Dataset Information

Factor structure and short version of the modified Fresno test to assess the use of the evidence-based practice in physiotherapists.

ABSTRACT:

Background

The Modified Fresno Test has been used to evaluate the use of the Evidence-Based Physiotherapy (EBP). So far, none of the versions of the Fresno Test were subjected to analysis of the factorial structure. The objective of the study was to describe the exploratory and confirmatory factor structure of the Modified Fresno Test adapted to the Portuguese-Brazilian and analyze the statistical feasibility for the elaboration of a short version.

Methods

The questionnaire was applied with a convenience sample of 57 physiotherapists, being 36 professionals (13 of these also professors) and 21 students from the last semester of the physiotherapy course. Exploratory Factor Analysis (EFA) was performed by the method of principal components. Confirmatory Factor Analysis (CFA) was performed by the method of maximum likelihood. The total score of the answers in the test and retest was evaluated, totalling 228 observations. Reliability was assessed by means of internal consistency, using Cronbach's alpha coefficient.

Results

Reliability was satisfactory (? 0.81) for all questions of the instrument. The coefficient ? calculated for the corrected item-total showed values higher than 0.20 except for item 9. Preliminary tests for Exploratory Factor Analysis showed acceptable values with Kaiser-Meyer-Olkin (KMO?=?0.80) and Bartlett's test of sphericity [chi-square (78)?=?1149.615, p??1), which explains 60.9% of the instrument's total variance. In Confirmatory Factor Analysis, none of the indices came close to an acceptable level (? 0.90), however, the second model which tested a three-factor structure provided a better fit to the data. From the results of this study the Modified Fresno Test short version was drawn.

Conclusion

The analysis showed good factor validity and adequate internal consistency for the use of the instrument consisting of 13 questions and 3 factors. This model proved to be better than the original model. The short version consisting of 9 questions may be an appropriate alternative for use in the population of interest.

SUBMITTER: da Silva AM

PROVIDER: S-EPMC7912886 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Factor structure and short version of the modified Fresno test to assess the use of the evidence-based practice in physiotherapists.

da Silva Anderson Martins AM Padula Rosimeire Simprini RS

BMC medical education 20210227 1

<h4>Background</h4>The Modified Fresno Test has been used to evaluate the use of the Evidence-Based Physiotherapy (EBP). So far, none of the versions of the Fresno Test were subjected to analysis of the factorial structure. The objective of the study was to describe the exploratory and confirmatory factor structure of the Modified Fresno Test adapted to the Portuguese-Brazilian and analyze the statistical feasibility for the elaboration of a short version.<h4>Methods</h4>The questionnaire was ap ...[more]

PMID: 33639895

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Project description:BackgroundHealth care educators need valid and reliable tools to assess evidence based practice (EBP) knowledge and skills. Such instruments have yet to be developed for use among physical therapists. The Fresno Test (FT) has been validated only among general practitioners and occupational therapists and does not assess integration of research evidence with patient perspectives and clinical expertise. The purpose of this study was to develop and validate a modified FT to assess EBP knowledge and skills relevant to physical therapist (PT) practice.MethodsThe FT was modified to include PT-specific content and two new questions to assess integration of patient perspectives and clinical expertise with research evidence. An expert panel reviewed the test for content validity. A cross-sectional cohort representing three training levels (EBP-novice students, EBP-trained students, EBP-expert faculty) completed the test. Two blinded raters, not involved in test development, independently scored each test. Construct validity was assessed through analysis of variance for linear trends among known groups. Inter and intra-rater reliability, internal consistency, item discrimination index, item total correlation, and difficulty were analyzed.ResultsAmong 108 participants (31 EBP-novice students, 50 EBP-trained students, and 27 EBP-expert faculty), there was a statistically significant (p < 0.0001) difference in total score corresponding to training level. Total score reliability and psychometric properties of items modified for discipline-specific content were excellent [inter-rater (ICC (2,1)] = 0.91); intra-rater (ICC (2,1)] = 0.95, 0.96)]. Cronbach's alpha was 0.78. Of the two new items, only one had strong psychometric properties.ConclusionsThe 13-item modified FT presented here is a valid, reliable assessment of physical therapists' EBP knowledge and skills. One new item assesses integration of patient perspective as part of the EBP model. Educators and researchers may use the 13-item modified FT to evaluate PT EBP curricula and physical therapists' EBP knowledge and skills.

Project description:BACKGROUND:Work addiction is a significant public health problem with a growing prevalence. The Work Addiction Risk Test (WART) is the gold standard questionnaire to detect workaholism. OBJECTIVE:The main objective of this study was to validate the French version of the WART. METHODS:Questionnaires were proposed to voluntary French workers using the WittyFit software. There were no exclusion criteria. The questionnaire was administered anonymously for initial validity testing and readministered one week later for test-retest reliability. We also assessed the workers' sociodemographic characteristics, as well as other measurements for external validity, such as stress, well-being, and coaddictions to tobacco, alcohol, and cannabis. Several psychometric properties of the French-WART were explored: acceptability, reliability (internal consistency [Cronbach alpha coefficient] and reproducibility [Lin concordance coefficient]), construct validity (correlation coefficients and principal component analysis), and external validity (correlation coefficients). RESULTS:Among the 1580 workers using WittyFit, 187 (11.83%) agreed to complete the WART questionnaire. Of those, 128 completed the test-retest survey (68.4%). Acceptability found that all respondents had fully completed the questionnaire, with few floor or ceiling effects. Reliability was very good with a Cronbach alpha coefficient at .90 (internal consistency) and Lin concordance coefficient at .90 (95% CI .87-.94] with a difference on the retest of .04 (SD 4.9) (95% CI -9.6 to 9.7) (reproducibility). We identified three main dimensions (construct validity). Relationships between WART and stress and well-being confirmed its external validity. CONCLUSIONS:The French version of the WART is a valid and reliable instrument to assess work addiction with satisfactory psychometric properties. Used in occupational medicine, this tool would allow the diagnosis of work addiction and can be easily implemented in current practice.

Project description:ObjectiveNational and international medical organizations and boards have recognized the importance of Evidence Based Medicine (EBM) and emphasized that EBM training should be included in medical education programs. Although some Turkish medical schools have developed and implemented EBM training programs, no validated Turkish language assessment tool has been available to compare the effectiveness of these training programs to national or international standards. The aim of this study is to cross-culturally adapt the Fresno Test, which is a validated English language tool utilized worldwide in the assessment of EBM training.MethodsThis study is a cross-sectional validation study, which was performed in two stages: Cross-cultural adaptation of the Fresno Test into Turkish; and evaluation of the psychometric properties, validity, reliability and responsiveness, of the Turkish version of the Fresno Test.ResultsThe content validity of the test was evaluated by experienced physicians in the field of Evidence-Based Medicine, and the content validity index was 1.00. The Cronbach α coefficient was 0.78 on the post-test results. The intraclass correlation (ICC) coefficient and the kappa analysis were calculated to evaluate inter-rater reliability. The ICC coefficients ranged from 0.66 to 0.97 for pre- and post-test results. The Kappa coefficients were 1.00 for all pre-test and post-test questions except one post-test question which was 0.89. The change score of the Fresno Test was used to evaluate responsiveness. The students' score of the Turkish Fresno Test was 49.9 ±18.2 pre-training and 118.9 ±26.3 post-training with a change of 69 points (95% CI, 63.9-74.2). The Cohen's effect size was 3.04 (95% CI, 2.6-3.5) indicating a very large change in scores.ConclusionsThe Turkish adapted Fresno Test used to evaluate students' success and program effectiveness is a valid and reliable measurement tool. It will be of great benefit for the comparison of the effectiveness of Turkish education programs nationally and cross-culturally.

Project description:BackgroundA psychometrically robust measurement instrument is prerequisite to tailor and monitor interventions aiming to improve evidence-based practice (EBP). The recently developed "Evidence-based Practice Inventory" (EBPI) questionnaire (five dimensions) provides a sound inventory for a comprehensive assessment of adherence to EBP, and identification of barriers and facilitators for EBP. The aims of this study were to establish a German language version of the EBPI and to examine the instrument's reliability in a diverse sample of healthcare professionals.MethodsThe English version of the EBPI was translated, adopted and subsequently test-retest reliability of the German language EBPI was examined in a nationwide online survey. Participants working in Germany were invited to complete the questionnaire twice. For each EBPI dimension, internal consistency reliability (Cronbach's alpha) and the relative test-retest reliability (intraclass correlation coefficient, ICC) were calculated. The standard error of measurement, limits of agreement and minimal detectable change values were estimated to quantify measurement error.ResultsA German language version of the EBPI was established. In the online survey, the EBPI was initially completed by 889 healthcare professionals. At follow-up, 344 individuals (39%) completed the questionnaire (74% female; mean work experience: 13.6 years). The ICCs for the five dimensions varied between 0.78 and 0.86. The standard error of measurement varied between 6.5 and 8.8% of the respective dimension scale range, and the limits of agreement between 24 and 37%. For internal consistency reliability, alpha varied between 0.64 and 0.90. There were neither floor nor ceiling effects, nor any other relevant feasibility issues.ConclusionsThe German language EBPI can be used to assess EBP adherence of healthcare professionals in clinical practice, and to identify barriers and facilitators for an EBP conform behaviour. Results on test-retest reliability indicate that the EBPI produces reliable scores when used for group comparisons, but the questionnaire seems insufficiently reliable for individual measurements over time. Methods of item response theory or Rasch measurement theory should be used for further evaluation and revision of the EBPI, informed by the results of this study.Trial registrationGerman Clinical Trials Register ( DRKS00013792 ). Registered 19 January 2018.

Project description:BackgroundTraining in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce.MethodsA prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP2), which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts), Confidence, Practice (EBP implementation), Sympathy (disposition towards EBP)]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES) (95% CI) were calculated for all changes.ResultsEffect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42). While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29) followed by an improvement in the second year (ES +0.27). Scores in Terminology improved (ES +0.19 to +0.26) in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19) in the first year and improved minimally in the second year (ES +0.04). Confidence scores improved during the second workforce year (ES +0.27). Scores for Sympathy showed little change.ConclusionsDuring the first two years in the workforce, there was a transitory decline in the self-reported practice and sense of relevance of EBP, despite increases in confidence and knowledge. The pattern of progression of EBP skills beyond these early professional working years is unknown.

Project description:BackgroundDisability is an increasingly important health-related outcome to consider as more individuals are now aging with Human Immunodeficiency Virus (HIV) and multimorbidity. The HIV Disability Questionnaire (HDQ) is a patient-reported outcome measure (PROM), developed to measure the presence, severity and episodic nature of disability among adults living with HIV. The 69-item HDQ includes six domains: physical, cognitive, mental-emotional symptoms and impairments, uncertainty and worrying about the future, difficulties with day-to-day activities, and challenges to social inclusion. Our aim was to develop a short-form version of the HIV Disability Questionnaire (SF-HDQ) to facilitate use in clinical and community-based practice among adults living with HIV.MethodsWe used Rasch analysis to inform item reduction using an existing dataset of adults living with HIV in Canada (n = 941) and Ireland (n = 96) who completed the HDQ (n = 1037). We evaluated overall model fit with Cronbach's alpha and Person Separation Indices (PSIs) (≥ 0.70 acceptable). Individual items were evaluated for item threshold ordering, fit residuals, differential item functioning (DIF) and unidimensionality. For item threshold ordering, we examined item characteristic curves and threshold maps merging response options of items with disordered thresholds to obtain order. Items with fit residuals > 2.5 or less than - 2.5 and statistically significant after Bonferroni-adjustment were considered for removal. For DIF, we considered removing items with response patterns that varied according to country, age group (≥ 50 years versus < 50 years), and gender. Subscales were considered unidimensional if ≤ 5% of t-tests comparing possible patterns in residuals were significant.ResultsWe removed 34 items, resulting in a 35-item SF-HDQ with domain structure: physical (10 items); cognitive (3 items); mental-emotional (5 items); uncertainty (5 items); difficulties with day-to-day activities (5 items) and challenges to social inclusion (7 items). Overall models' fit: Cronbach's alphas ranged from 0.78 (cognitive) to 0.85 (physical and mental-emotional) and PSIs from 0.69 (day-to-day activities) to 0.79 (physical and mental-emotional). Three items were rescored to achieve ordered thresholds. All domains demonstrated unidimensionality. Three items with DIF were retained because of their clinical importance.ConclusionThe 35-item SF-HDQ offers a brief, comprehensive disability PROM for use in clinical and community-based practice with adults living with HIV.

Dataset Information

Factor structure and short version of the modified Fresno test to assess the use of the evidence-based practice in physiotherapists.

Background

Methods

Results

Conclusion

Publications

Factor structure and short version of the modified Fresno test to assess the use of the evidence-based practice in physiotherapists.

Similar Datasets

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