Performance of the Norwegian SF-36 Health Survey in patients with rheumatoid arthritis. II. A comparison of the SF-36 with disease-specific measures

The performance of the SF-36 was compared with disease-specific health status instruments (Arthritis Impact Measurements Scales [AIMS2], Modified Health Assessment Questionnaire [MHAQ] and visual analogue scales) in 1030 patients with rheumatoid arthritis (mean age 62.3 years, 79% females, mean disease duration 12.9 years, 48% rheumatoid factor positive). The scales performed similarly in known group comparisons (age cohorts, disease severity, disease activity, comorbidity). The SF-36 physical functioning scale correlated -0.69 and -0.73 with the MHAQ and AIMS2 physical scales, respectively. A strong negative correlation was found with the walking and bending subscale of AIMS2 (r = -0.80), a substantial negative correlation with mobility (r = -0.65), and moderate correlations with the scales for hand/finger and arm function (r = -0.52 and r = -0.53). Frequency distributions of scores revealed more skewed distributions of the AIMS2 physical scale and the MHAQ scale than the physical functioning scale of the SF36, whereas the pain and mental health scales were distributed similarly. In conclusion, the SF-36 performs well in patients with rheumatoid arthritis. The physical functioning scale of the SF-36 does not seem to capture all aspects of physical health in rheumatoid arthritis patients, but may be more sensitive than disease-specific measures to low levels of physical disability.     

Development of a scale to measure cross-cultural sensitivity in the Canadian context.

Presents a scale to measure cross-cultural awareness and understanding in the Canadian context. Rational-empirical scale construction methodologies were used to produce the measure. 55 undergraduates and 10 geologists were used to evaluate items in the scale: The 24 best items were selected as a tentative Cross-Cultural Sensitivity Scale (CCSS). Parallel forms (12-item scales) were developed and tested using 71 undergraduate students. Data demonstrate that the CCSS, both the 24-item and the shorter forms, show reasonable levels of content validity and impressive internal consistency. Further work on this scale is indicated. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment

Data from general population surveys (n = 1483 to 9151) in nine European countries (Denmark, France, Germany, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom) were analyzed to cross-validate the selection of questionnaire items for the SF-12 Health Survey and scoring algorithms for 12-item physical and mental component summary measures. In each country, multiple regression methods were used to select 12 SF-36 items that best reproduced the physical and mental health summary scores for the SF-36 Health Survey. Summary scores then were estimated with 12 items in three ways: using standard (U.S.-derived) SF-12 items and scoring algorithms; standard items and country-specific scoring; and country-specific sets of 12 items and scoring. Replication of the 36-item summary measures by the 12-item summary measures was then evaluated through comparison of mean scores and the strength of product-moment correlations. Product-moment correlations between SF-36 summary measures and SF-12 summary measures (standard and country-specific) were very high, ranging from 0.94-0.96 and 0.94-0.97 for the physical and mental summary measures, respectively. Mean 36-item summary measures and comparable 12-item summary measures were within 0.0 to 1.5 points (median = 0.5 points) in each country and were comparable across age groups. Because of the high degree of correspondence between summary physical and mental health measures estimated using the SF-12 and SF-36, it appears that the SF-12 will prove to be a practical alternative to the SF-36 in these countries, for purposes of large group comparisons in which the focus is on overall physical and mental health outcomes.     

Combining activities of daily living with instrumental activities of daily living to measure functional disability

Measures of functional disability typically contain items that reflect limitations in performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Combining IADL and ADL items together in the same scale would provide enhanced range and sensitivity of measurement. This article presents psychometric justification for a combined ADL/IADL scale. Data come from 2,977 disabled respondents in the 1989 National Long-Term Care Survey. Respondents indicated whether they received human help on 7 ADL items; they also indicated whether they were unable to perform each of 9 IADL items due to health reasons. Factor analyses using tetrachoric correlations demonstrated that 15 of the 16 items reflected one major dimension. Item response theory (IRT) methods were used to calibrate the items; a one-parameter IRT model fit the data. Item calibrations showed that ADL and IADL items were not hierarchically related. Analyses showed that a simple sum of item responses could be used to derive a measure of functional disability. Implications of using a 15-item ADL/IADL scale for eligibility determination and for comparing groups are discussed.     

Physical disability construct convergence across instruments: towards a universal metric

OBJECTIVES: This study examines the stability of a physical disability construct across instruments and samples. The purpose is not to report a formal equating of instrument calibrations, but to indicate whether such an effort would be likely to succeed. Theory. The economics transforming health care from its orientation toward crisis-driven disease reactions to population- and evidence-based preventive health management and individualized disease management demand general scale-free measures of functional independence. METHODS: A new method, pseudo-common item equating, is demonstrated. Similar, but not identical items, from different instruments, calibrated on different samples, are compared. DATA: More than 30 articles presenting Rasch analyses of physical functioning scales were reviewed. Four instruments provided data from ten of these articles, for eleven different calibrations (two instruments are both included in one article). RESULTS: The final overall average correlation disattenuated for error is .93, with an average of 7 pseudo-common items, and an average p-value of .01, meaning that measures based on these calibrations should be linearly transformable versions of the same metric. Scientific importance. The quantitative stability of different areas of physical functional independence across instruments and samples suggests that the development and deployment of a universal metric is a realizable goal.     

The couple version of FACES III: Validity and reliability.

512 Australian couples completed the couple version of D. H. Olson's (1985) Family Adaptability and Cohesion Evaluation Scale III (FACES III), which was devised to measure family functioning. While the items of FACES III were all useful in discriminating between couples high and low on the 2 factors (adaptability and cohesion), the construct validity was not supported by factor analyses. Construct validity problems may be overcome, at least to some extent, by using a 17-item version of the scale consisting of a 10-item cohesion factor and a 7-item change factor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A managerial potential scale for the California Psychological Inventory.

Evaluated the good manager scale of the California Psychological Inventory developed by L. D. Goodstein and W. J. Schrader (see record 1963-08352-001) against criteria of managerial competence and managerial interests. Managerial competence and managerial interests were indexed by performance ratings of 200 military officers and item endorsements of 49 young bank managers, respectively. Endorsement rates by bank managers of the 206 items were contrasted with the endorsement rates for high school students, college students, and men in general on file in the author's archives. The resulting 34-item managerial potential (MP) scale correlated highly (.88 and .89) with the original measure in normative samples of 1,000 males and females, respectively. Alpha reliabilities were .75 for both sexes. In a new sample of 143 military officers, MP correlated .20 with criterion ratings. Rankings of 26 male and 20 female Ss by MP mean scores showed agreement with presumed level of managerial functioning. MP was found to be diagnostic of behavioral effectiveness, self-confidence, cognitive clarity, and goal orientation for both sexes. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bifactor and item response theory analyses of interviewer report scales of cognitive impairment in schizophrenia.

A psychometric analysis of 2 interview-based measures of cognitive deficits was conducted: the 21-item Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS; Ventura et al., 2008), and the 20-item Schizophrenia Cognition Rating Scale (SCoRS; Keefe et al., 2006), which were administered on 2 occasions to a sample of people with schizophrenia. Traditional psychometrics, bifactor analysis, and item response theory methods were used to explore item functioning and dimensionality and to compare instruments. Despite containing similar item content, responses to the CGI-CogS demonstrated superior psychometric properties (e.g., higher item intercorrelations, better spread of ratings across response categories) relative to the SCoRS. The authors argue that these differences arise mainly from the differential use of prompts and how the items are phrased and scored. Bifactor analysis demonstrated that although both measures capture a broad range of cognitive functioning (e.g., working memory, social cognition), the common variance on each is overwhelmingly explained by a single general factor. Item response theory analyses of the combined pool of 41 items showed that measurement precision is peaked in the mild to moderate range of cognitive impairment. Finally, simulated adaptive testing revealed that only about 10 to 12 items are necessary to achieve latent trait level estimates with reasonably small standard errors for most individuals. This suggests that these interview-based measures of cognitive deficits could be shortened without loss of measurement precision. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: results from the IQOLA Project. International Quality of Life Assessment

Data from general population samples in 11 countries (n = 1483 to 9151) were used to assess data quality and test the assumptions underlying the construction and scoring of multi-item scales from the SF-36 Health Survey. Across all countries, the rate of item-level missing data generally was low, although slightly higher for items printed in the grid format. In each country, item means generally were clustered as hypothesized within scales. Correlations between items and hypothesized scales were greater than 0.40 with one exception, supporting item internal consistency. Items generally correlated significantly higher with their own scale than with competing scales, supporting item discriminant validity. Scales could be constructed for 93-100% of respondents. Internal consistency reliability of the eight SF-36 scales was above 0.70 for all scales, with two exceptions. Floor effects were low for all except the two role functioning scales; ceiling effects were high for both role functioning scales and also were noteworthy for the Physical Functioning, Bodily Pain, and Social Functioning scales in some countries. These results support the construction and scoring of the SF-36 translations in these 11 countries using the method of summated ratings.     

Development of the quality of life in epilepsy inventory

We developed an instrument to measure health-related quality of life (HRQOL) in epilepsy. A 99-item inventory was constructed from the RAND 36-Item Health Survey (generic core), with 9 additional generic items, 48 epilepsy-targeted items, and 6 other items concerning attitudes toward epilepsy and self-esteem. We administered the 99-item inventory to 304 adults with epilepsy at 25 epilepsy centers. Patients and patient-designated proxies completed the inventory and were retested 1-91 days later. A multitrait scaling analysis of these data led to retention of 86 items distributed in 17 multiitem scales (Cronbach's alpha ranged from 0.78 to 0.92). Factor analysis of the 17 multiitem scales yielded four underlying dimensions of health: an epilepsy-targeted dimension, a cognitive factor, mental health, and physical health. Construct validity was supported by significant patient-proxy correlations for all scales and correlations between neuropsychologic tests and self-reported emotional and cognitive function (all p values < 0.05). There were significant negative correlations between the four factor scores derived from the HRQOL scales and neurotoxicity, systemic toxicity, and health care utilization (except for the correlation between mental health factor and health care utilization; all p values < 0.05). Patients who were seizure-free in the preceding year reported better HRQOL for the overall score, three of the four factor scores, and 8 of the 17 scale scores than did patients with a high frequency of seizures. Relative validity analysis showed that the epilepsy-targeted factor and three of its four component scales were more sensitive to categorization of patients by severity of seizure frequency and type than scales tapping physical health, mental health, or cognitive function. These cross-sectional data support the reliability and validity of this measure of HRQOL in epilepsy. The addition of an epilepsy-targeted supplement to the generic core improved the sensitivity to severity of epilepsy. The 86 items included in the field testing were supplemented by three additional items to form the Quality of Life in Epilepsy (QOLIE-89) inventory.     

Ethnocentrism and misanthropy.

"Twenty-nine items from existing scales of ethnic prejudice were rewritten so that the terms 'people' or 'most people' or 'humans' were substituted for the specific minorities originally designated. The scale thus constructed (termed M for misanthropy) was found to be correlated .43 (.53 when corrected for attenuation) with a 20-item version of the UC-POS scale for general ethnic intolerance. The results of the study were discussed with reference to the possible connections between prejudice and misanthropy." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptual and enactment measurement of self-care

The concept of self-care was conceptualized as having three major components: enabling perceptual elements (motivation, values, responsibility, and decision making); domains for enactment (cognitive/ perceptual, psychosocial/affective, and physical functioning); and self-care enactment factors (capacity), which included self-care action and knowledge adequate for self-care. A new tool, The Self-Care Agency Inventory, was designed to discriminate between those who will enact self-care and those who will not because of either a lack of knowledge or a lack of motivation. Content validity was demonstrated (.77 or greater from each scale) and concurrent validity documented. Alpha reliability for the new scale and principal components factor analysis of the scale items did not achieve desired levels, although a pilot sample demonstrated test-retest reliability of .82. The conceptual model is presented.     

Development and validation of the Miami University Diversity Awareness Scale (MUDAS).

College students need to be prepared for a global environment, and assessing student awareness about issues of diversity is critical to this preparation. This study chronicles the validation of the Miami University Diversity Awareness Scale (MUDAS). This instrument is designed to measure the level of student awareness about issues of culture, intergroup interaction, social justice, and the degree to which students believe these issues are presented in the college classroom. An exploratory factor analysis suggested that the 29-item scale produced a 5-factor model showing good fit of the data. A follow-up instrument revision included the addition of 8 items resulting in a refined 37-item survey. Construct validity and reliability issues were addressed. Incoming first-year student MUDAS results are examined and implications for future research and practice are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Flow injection with chemical reaction interface-isotope ratio mass spectrometry: an alternative to off-line combustion for detecting low levels of enriched 13C in mass balance studies

Current methods to assess voice outcomes in patients with unilateral vocal cord paralysis (UVCP) are limited by expense, reliability, or lack of a true patient-relevant focus. The purpose of this study was to develop and validate a patient-based, disease-specific instrument, the Voice Outcome Survey (VOS), that is brief, reliable, and sensitive to real clinical change in patients with UVCP. Fifty-six consecutive patients with uncompensated UVCP and without complicating comorbid illness received the VOS, the Medical Outcome Study Short Form 36-Item Health Survey (SF-36), and a voice laboratory analysis before and 6 months after type I thyroplasty. Overall, reliability of the VOS was excellent (r = 0.87, P < 0.0001). The VOS index was significantly (P < 0.05) correlated to subscales of the SF-36 including social functioning (SF) (r = 0.56) and physical role functioning (r = 0.35), as well as changes in objective voice measures such as phonation time (r = 0.51) and average intensity (r = 0.44). The VOS index was the most sensitive measure to clinical change after surgery (standardized response means: VOS, 1.92; phonation time, 0.68; SF, 0.58; physical role functioning, 0.53; intensity, 0.51). The VOS is a brief, valid, reliable, and highly sensitive measure of disease-specific health status in patients with UVCP.     

Evaluation of three circadian rhythm questionnaires with suggestions for an improved measure of morningness.

Circadian rhythms, cyclic fluctuations in many physiological and psychological functions, are thought to influence adjustment to shiftwork. A widely acknowledged individual difference in circadian rhythms, commonly called morningness, indicates preferences associated with morning or evening activities. Various self-report instruments have been developed to measure morningness, although little measurement data have been published for these scales. Because morningness scales are being used to select workers for night shiftwork, psychometric evaluations of these scales are needed. Psychometric assessments of undergraduate responses (N?=?501) on three widely used scales indicate internal (interitem) measurement deficiencies in all three. Therefore, a 13-item scale was developed that distills the best items from two of these scales. Relationships between the new composite scale and external criteria are comparable with or stronger than similar relationships between the published scales and external criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring battering: development of the Women's Experience with Battering (WEB) Scale

Measuring only the physical markers of violence (e.g., slapping, beating) fails to capture the chronic vulnerability and gendered nature of battered women's experiences. Instruments that measure only observable discrete events may mask the continuous nature of battering and the relation between events and experience. Our approach to measuring battering operationalizes the experiences of battered women rather than the abusive behaviors they encounter. This alternative approach emphasizes the meanings battered women attach to the violence and to battering as an enduring presence in their lives. Focus groups with 22 battered women generated qualitative data for developing scale items (Smith, Tessaro, & Earp, 1995) and a known-groups survey with 185 battered and 204 nonbattered women determined the final scale items. Factor analysis of 40 initial items revealed a strong single-factor solution. The resulting 10-item Women's Experiences with Battering (WEB) Scale demonstrated high internal consistency reliability, was significantly correlated with known-group status, exhibited good construct validity, and was not significantly correlated with a measure of social desirability. The WEB Scale provides researchers with a valid and concise measure for studying relations between battering and health or health behavior, as well as evaluating the impact of interventions on battered women or prevalence.     

Psychological empowerment: Definition, measurement, and validation.

Psychological empowerment was defined from the perspective of the individual employee, and a measure was developed using three different samples. The psychologically empowered state was considered to be a cognitive state characterized by a sense of perceived control, perceptions of competence, and internalization of the goals and objectives of the organization. Using an initial sample of 311 employed individuals (mean age 30 yrs), a 9-item, 3-factor scale of psychological empowerment was developed with subscale reliabilities as follows: perceived control (.83), perceived competence (.80), and goal internalization (.88). In the validation sample of 66 employees from a single organization, empowerment as measured by the scale was negatively related to organizational centralization while being positively related to delegation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-cultural comparisons of the content of SF-36 translations across 10 countries: results from the IQOLA Project. International Quality of Life Assessment

Increasingly, translated and culturally adapted health-related quality of life measures are being used in cross-cultural research. To assess comparability of results, researchers need to know the comparability of the content of the questionnaires used in different countries. Based on an item-by-item discussion among International Quality of Life Assessment (IQOLA) investigators of the content of the translated versions of the SF-36 in 10 countries, we discuss the difficulties that arose in translating the SF-36. We also review the solutions identified by IQOLA investigators to translate items and response choices so that they are appropriate within each country as well as comparable across countries. We relate problems and solutions to ratings of difficulty and conceptual equivalence for each item. The most difficult items to translate were physical functioning items that refer to activities not common outside the United States and items that use colloquial expressions in the source version. Identifying the origin of the source items, their meaning to American English-speaking respondents and American English synonyms, in response to country-specific translation issues, greatly helped the translation process. This comparison of the content of translated SF-36 items suggests that the translations are culturally appropriate and comparable in their content.