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Assessment of the factorial validity and reliability of the ALSFRS-R: a revision of its measurement model.

ABSTRACT: The amyotrophic lateral sclerosis functional rating scale-revised (ALSFRS-R) is a widely used primary outcome measure in amyotrophic lateral sclerosis (ALS) clinical practice and clinical trials. ALSFRS-R items cannot, however, validly be summed to obtain a total score, but constitute domain scores reflecting a profile of disease severity. Currently, there are different measurement models for estimating domain scores. The objective of the present study is, therefore, to derive the measurement model that best fits the data for a valid and uniform estimation of ALSFRS-R domain scores. Data from 1556 patients with ALS were obtained from a population-based register in The Netherlands. A random split of the sample provided a calibration and validation set. Measurement models of the ALSFRS-R were investigated using both exploratory factor analyses and confirmatory factor analyses. The measurement model with a four-factor structure (i.e., bulbar, fine motor, gross motor, and respiratory function), with correlated factors and cross-loading items on dressing and hygiene and turning in bed and adjusting bed clothes on both motor function scales, provided the best fit to the data in both sets. Correlation between factors ranged from weak to modest, confirming that the ALSFRS-R constitutes a profile of four clinically relevant domain scores rather than a total score that expresses disease severity. The internal consistency of the four domain scores was satisfactory. Our revision of the measurement model may allow for a more adequate estimation of disease severity and disease progression in epidemiological studies and clinical trials.

SUBMITTER: Bakker LA

PROVIDER: S-EPMC5502060 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Assessment of the factorial validity and reliability of the ALSFRS-R: a revision of its measurement model.

Bakker Leonhard A LA Schröder Carin D CD van Es Michael A MA Westers Paul P Visser-Meily Johanna M A JMA van den Berg Leonard H LH

Journal of neurology 20170612 7

The amyotrophic lateral sclerosis functional rating scale-revised (ALSFRS-R) is a widely used primary outcome measure in amyotrophic lateral sclerosis (ALS) clinical practice and clinical trials. ALSFRS-R items cannot, however, validly be summed to obtain a total score, but constitute domain scores reflecting a profile of disease severity. Currently, there are different measurement models for estimating domain scores. The objective of the present study is, therefore, to derive the measurement mo ...[more]

PMID: 28608303

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Project description:BackgroundA nursing student's reflection on their knowledge and competence in patient safety (PS) may prepare them to provide safer care in certain circumstances. The Health Professional Education in PS Survey (H-PEPSS) is a validated tool for assessing the perceptions of nursing students with regards to competence in PS. The H-PEPSS is widely used internationally but is not available in Chinese.ObjectivesThis study aimed to translate the H-PEPSS into Chinese and test its psychometric properties among Chinese undergraduate nursing students.DesignThis was a cross-sectional online survey that was conducted in 2018.SettingsSeven nursing schools in North, East, Northeast, Central, Southwest, South, and Northwest China.ParticipantsA total of 732 final-year undergraduate nursing students were recruited by convenience sampling.MethodsTranslation was conducted rigorously in accordance with an adapted version of Brislin's translation model. Psychometric evaluation was conducted by incorporating classical test theory and item response theory (IRT) analysis.ResultsThe Chinese version of the H-PEPSS (both the classroom and clinical practice versions) achieved a Cronbach's ?, marginal reliability and 2-week test-retest reliability of >0.85. A six-factor solution explaining 81.49% and 82.32% of the total variance was obtained for the classroom and clinical practice versions, respectively. This was further validated by confirmatory factor analysis. IRT analysis showed that the scale offers a broad range of information on PS competence and discriminates efficiently between patients with high and low levels of competence in PS.ConclusionThe Chinese version of the H-PEPSS is a reliable and valid instrument that is capable of evaluating competence in PS perceived by undergraduate nursing students. In addition, the survey may also be used to evaluate gaps in classroom knowledge and clinical competence, and to offer valid data for designing or tailoring new education strategies.

Project description:BackgroundThis study aimed to assess the factorial validity and reliability of the Pandemic Stressor Scale (PaSS), a new measure to assess the severity of distress for different stressors relevant during a pandemic or epidemic.MethodsThe PaSS was administered in N = 2760 German participants. Exploratory factor analysis was used to extract factors. The factor structure obtained in the German sample was examined in N = 1021 Austrian participants using confirmatory factor analysis. χ2, RMSEA, SRMR, CFI, TLI were assessed as global goodness of fit indices for two models (Model 1: nine-factor model; Model 2: nine-factor model combined with a second-order general factor). We additionally assessed factor loadings, communalities, factor reliability, discriminant validity as local fit indices. Internal consistency, item discrimination, and item difficulty were assessed as additional test quality criteria.ResultsThe results of the exploratory factor analysis suggested a nine-factor solution with factor loadings accounting for 50.4% of the total variance (Factor 1 'Problems with Childcare', Factor 2 'Work-related Problems', Factor 3 'Restricted Face-to-Face Contact', Factor 4 'Burden of Infection ', Factor 5 'Crisis Management and Communication', Factor 6 'Difficult Housing Condition', Factor 7 'Fear of Infection', Factor 8 'Restricted Access to Resources', Factor 9 'Restricted Activity'). The confirmatory factor analysis showed a sufficient global fit for both tested models (Model 1: χ2 (369, N = 1021) = 1443.28, p < .001, RMSEA = .053, SRMR = .055, CFI = .919, TLI = .904; Model 2: χ2 (396, N = 1021) = 1948.51, p < .001, RMSEA = .062, SRMR = .074, CFI = .883, TLI = .871). The results of the chi-square difference test indicated a significantly better model-fit of Model 1 compared to Model 2 (∆χ2 (27, N = 1021) = 505.23, p < .001). Local goodness of fit indices were comparable for both tested models. We found good factor reliabilities for all factors and moderate to large factor loadings of the items as indicators. In Model 2, four first-order factors showed small factor loadings on the second-order general factor.ConclusionThe Pandemic Stressor Scale showed sufficient factorial validity for the nine measured domains of stressors during the current COVID-19 pandemic.

Project description:BackgroundBased on the self-determination theory, the psychological requirements for competence, autonomy, and relatedness boost beneficial exercise behaviour for healthy living. However, there is no valid, reliable Malay version scale to investigate the extent to which these psychological needs are met. The main purpose of this study was to examine the psychometric properties of a Malay version of the Psychological Need Satisfaction in Exercise (PNSE-M) scale. In addition, the purpose of this study was to confirm the measurement and structural invariance of the PNSE-M across gender.MethodsThe study participants included 919 students (male: 49.6%, female: 50.4%), with a mean age of 20.4 years (standard deviation = 1.5). The participants were selected through convenience sampling. The 18-item PNSE-M was used to measure psychological need satisfaction in exercise. The English version of the PNSE was translated into Malay using standard forward-backward translation. Confirmatory factor analysis (CFA) and invariance tests were performed on the three domains of the PNSE-M model. Composite reliability (CR), average variance extracted (AVE), internal consistency based on Cronbach's alpha, and test-retest reliabilities using intraclass correlation coefficient (ICC) were also computed.ResultsAfter some model re-specification, the CFA findings based on the hypothesised measurement model of three factors and 18 items indicated acceptable factor structure (CFI = .936, TLI = .923, SRMR = .054, RMSEA = .059). The CR and AVE values were .864-.902 and .573-.617, respectively. Cronbach's alpha was .891-.908, and the ICC was .980-.985. The findings supported the full measurement and structural invariance of the PNSE-M for both male and female participants. The CFA model matched the data well for both male (CFI = .926, SRMR = .057, RMSEA = .066) and female (CFI = .926, SRMR = .060, RMSEA = .065) participants.ConclusionThe PNSE-M with three factors and 18 items is considered to be a valid, reliable instrument for university students in Malaysia. It is valid for use to make meaningful comparisons across gender.

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Assessment of the factorial validity and reliability of the ALSFRS-R: a revision of its measurement model.

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Assessment of the factorial validity and reliability of the ALSFRS-R: a revision of its measurement model.

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