Psychometric Evaluation of the Making it CLEAR Questionnaire: A Resilience Measure for Older Adults
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ABSTRACT: Background and Objectives
Previous efforts to develop a resilience measure for older adults have
SUBMITTER: Whitehall L
PROVIDER: S-EPMC8528023 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPhysical resilience is known to minimize the adverse outcomes of health stressors for older people. However, validated instruments that assess physical resilience in older adults are rare. Therefore, we aimed to validate the Physical Resilience Instrument for Older Adults (PRIFOR) to fill the literature gap.MethodsContent analysis with content validity was first carried out to generate relevant items assessing physical resilience for older adults, and 19 items were developed. Psychometric evaluation of the 19 items was then tested on 200 older adults (mean [SD] age = 76.4 [6.6] years; 51.0% women) for item properties, factor structure, item fit, internal consistency, criterion-related validity, and known-group validity.ResultsAll 19 items had satisfactory item properties, as they were normally distributed (skewness = -1.03 to 0.38; kurtosis = -1.05 to 0.32). However, two items were removed due to substantial ceiling effects. The retained 17 items were embedded in three factors as suggested by the exploratory factor analysis (EFA) results. All items except one had satisfactory item fit statistics in Rasch model; thus, the unidimensionality was supported for the three factors on 16 items. The retained 16 items showed promising properties in known-group validity, criterion-related validity, and internal consistency (α = 0.94).ConclusionsThe 16-item PRIFOR exhibits good psychometric properties. Using this instrument to measure physical resilience would be beneficial to identify factors that could protect older people from negative health consequence. With the use of the PRIFOR, intervention effects could also be evaluated. It is helpful to strengthen resilience and thereby facilitate successful aging.
| S-EPMC8935854 | biostudies-literature
Project description:The Patient Activation Measure (PAM) quantifies the extent to which people are informed about and involved in their health care. Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical, four-stage model of patient activation. Methods. A cross-sectional analysis was used to assess the psychometric properties of PAM. Internal consistency was assessed using Cronbach ?. Construct validity was evaluated using general linear modeling to compute associations between PAM scores and health-related behaviors, functional status, and health care quality. Latent class analysis was used to evaluate the theoretical four-stage structure of patient activation.Participants in a randomized trial of Guided Care (N = 855), a model of comprehensive health care for older adults with chronic conditions that put them at risk of using health services heavily during the coming year.Higher PAM activation scores and stage were positively associated with higher functional status, health care quality, and adherence to some health behaviors. Latent class analysis supported the multistage theory of patient activation.The PAM is a reliable, valid, and potentially clinically useful measure of patient activation for multimorbid older adults.
| S-EPMC3064914 | biostudies-literature
Project description:BackgroundThe world's growing population of older adults is one population that needs to be focused more regarding subjective well-being. It is therefore important to evaluate self-report instruments that measures general well-being for this specific group - older adults. The aim of the present study was to investigate psychometric properties of the Swedish translation of the GP-CORE (general population - Clinical Outcomes in Routine Evaluation) in a group of older adults (> 65 years).MethodsIn this study, a psychometric evaluation of the GP-CORE is presented for 247 Swedish older adults (> 65 years), 184 women and 63 men who applied for home care assistance for the first time.ResultsThe psychometric evaluation showed high acceptability; provided norm values in terms of means, standard deviations and quartiles; showed satisfactory reliability in terms of both internal consistency and stability; showed satisfactory validity in terms of convergent and discriminant validity; provided a very preliminary cut-off value and quite low sensibility and sensitivity and showed results which indicated that this scale is sensitive to changes. One gender difference was identified in that women without a cohabitant had a higher well-being than men without a cohabitant (as measured by GP-CORE).ConclusionsThe GP-CORE showed satisfactory psychometric properties to be used to measure and monitor subjective well-being in older adults (> 65 years) in the general population of community dwelling. Future studies should establish a cut-off value in relation to another well-being measure relevant for mental health in older adults.
| S-EPMC9706994 | biostudies-literature
Project description:BACKGROUND:Although the importance of care coordination (CC) is well-recognized, cancer patients often receive poorly coordinated care across varied care settings and different oncology providers. Efforts to improve cancer care are hampered by lack of adequate measures. In this two-part, mixed-method study, we describe the development, refinement, and validation of a new care coordination instrument (CCI) designed to assess cancer patients' perception of CC. METHODS:In Study 1, an initial CCI was developed incorporating questions based on literature review. The items were then modified following four field tests conducted in a large academic hospital with oncology nurses (n?=?20) and cancer patients (n?=?120). This modified instrument was used to determine whether the CCI was able to distinguish CC between two practices (30 GI and 30 myeloma patients) within the same hospital setting. In Study 2, 68 patients receiving community-based care participated in seven focus groups. Based on these discussions, the CCI items were again refined, and psychometric evaluation was conducted to assess the quality of the instrument. RESULTS:Based on field tests, 3 domains of the CCI, Communication, Navigation, and Operational, were defined as critical components of CC. The Operational domain evaluates efficiency of care and is unique to this CCI. The field test demonstrated that GI patients reported significantly better CC Overall and for the Communication and Navigation domains (all p?<?.05). In Study 2, patients expressed concordance with the CCI items and their CC experiences, establishing validity of the CCI. Qualitative analysis of the focus group discussions indicated that the items with the highest frequencies of participants' comments were related to the concepts of Navigator, Team, Survey, and Communication. Quantitative analysis identified items with a limited response range or high rates of "neutral" responses; accordingly, those items were removed. The final CCI survey is a 29 item, multiple-choice questionnaire with excellent reliability, Cronbach's ??=?.922. CONCLUSIONS:We developed a novel, patient-centered tool with excellent psychometric properties that can be utilized across varied practice settings to assess patients' perception of cancer care coordination. TRIAL REGISTRATION:Not required; retrospectively registered ClinicalTrials.gov NCT03594006 20 July 2018.
| S-EPMC6975072 | biostudies-literature
Project description:BackgroundPsychometrically sound measures of chronic disease self-management tasks are needed to improve identification of patient needs and to tailor self-management programs. This study aimed to develop and conduct a preliminary psychometric analysis of the CanSMART questionnaire among a diverse, multimorbid Canadian population.MethodsThe data were drawn from a cross-sectional online survey to examine self-management needs and support preferences. Participants were 306 Canadian adults with one or more physical and/or emotional chronic conditions. The questionnaire on frequency of self-management tasks was developed with substantial patient partner input. We conducted Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) of the 11 self-management tasks comprising the scale in two randomly selected subsamples, followed by Rasch analysis. Associations between patient characteristics and the self-management task subscales and individual items were explored.ResultsThe factor analyses identified two self-management task subscales that were labelled Coping tasks (6 items) and Physical tasks (3 items), with Cronbach's alpha of 0.70 and 0.67, respectively. Rasch analysis suggested that participants had difficulty discriminating between response options "mostly" and "always". In analyses of independent associations with patient characteristics, both Coping and Physical tasks were associated with reporting more than one chronic disease and employment disability. The Coping tasks subscale was associated with female sex. Two items, on medication use and monitoring biological parameters, did not load on either scale. Both were associated with specific diagnoses.ConclusionsIn this preliminary analysis, two self-management tasks subscales exhibit good psychometric properties. Two items that did not load on either scale may represent additional dimensions of self-management. This work provides the basis for further scale development and use in research and clinical practice.
| S-EPMC9730574 | biostudies-literature
Project description:BackgroundAdministrative data sets lack functional measures.AimWe examined whether trajectories of cost can be used as a marker of functional recovery after hospitalization.MethodsSecondary analysis of the National Health and Aging Trends Study merged with Centers for Medicare and Medicaid Services data. Community-dwelling participants with a first hospitalization occurring after any annual survey were included (N = 937). Monthly total cost trajectories were constructed for the 3 months before and 3 months following hospitalization. Growth mixture models identified groups of patients with similar trajectories. The association of cost classes with five functional outcomes was examined using multivariate models, controlling for pre-hospitalization function and lead time.ResultsFour cost trajectory classes describing common recovery patterns were identified-persistently high, persistently moderate, low-spike-recover, and low variable. Cost class membership was significantly associated with change in Activities of Daily Living (ADL), instrumental ADL, Short Physical Performance Battery, and grip strength (p < 0.005), but not gait speed (p = 0.08). The proportion of patients who maintained or improved SPPB score was 46.8% in the persistently high, 49.2% in the persistently moderate, 52.7% in the low-spike-recover, and 57.2% in the low-variable groups. In models adjusted for known predictors of functional outcome, the magnitude and direction of association was maintained but significance was lost, indicating that cost trajectories' mirror is mediated by predictors of recovery not available in administrative data.ConclusionCost trajectories and total costs are associated with functional recovery following hospitalization in older adults. Cost may be useful as a measure of recovery in administrative data.
| S-EPMC7426235 | biostudies-literature
Project description:BackgroundThe concept of resilience has captured the imagination of researchers and policy makers over the past two decades. However, despite the ever growing body of resilience research, there is a paucity of relevant, comprehensive measurement tools. In this article, the development of a theoretically based, comprehensive multi-dimensional measure of resilience in adolescents is described.MethodsExtensive literature review and focus groups with young people living with chronic illness informed the conceptual development of scales and items. Two sequential rounds of factor and scale analyses were undertaken to revise the conceptually developed scales using data collected from young people living with a chronic illness and a general population sample.ResultsThe revised Adolescent Resilience Questionnaire comprises 93 items and 12 scales measuring resilience factors in the domains of self, family, peer, school and community. All scales have acceptable alpha coefficients. Revised scales closely reflect conceptually developed scales.ConclusionsIt is proposed that, with further psychometric testing, this new measure of resilience will provide researchers and clinicians with a comprehensive and developmentally appropriate instrument to measure a young person's capacity to achieve positive outcomes despite life stressors.
| S-EPMC3204306 | biostudies-literature
Project description:BackgroundEosinophilic esophagitis (EoE) is a chronic, inflammatory disease of the esophagus leading to symptoms of esophageal dysfunction; dysphagia is the most common symptom experienced by adults and adolescents.ObjectiveWe sought to perform a psychometric evaluation of the Dysphagia Symptom Questionnaire (DSQ), a patient-reported outcome measure for patients with EoE.MethodsUsing baseline and week 24 data from the randomized, interventional, multinational phase 3 R668-EE-1774 trial (NCT03633617), the measurement properties of the DSQ-including reliability, construct and known-groups validity, responsiveness, and interpretation of change-were evaluated.ResultsThe analysis population comprised 239 patients with EoE (age [mean ± SD], 28.1 ± 13.14 years; 63.6% male; 90.4% White). Intraclass correlation coefficients of 0.92 and 0.97 exceeded the acceptable reliability threshold (≥0.70). Construct validity correlations with EoE symptom and impact measures were moderate at baseline (|r| = 0.44-0.55) and week 24 (|r| = 0.55-0.69), and the DSQ biweekly total score discriminated among groups defined by disease severity. Analyses exploring interpretation of change from baseline on the DSQ biweekly total score indicated thresholds for within-patient improvement ranging from 9 to 23 points; a within-patient improvement from baseline of 13 points or greater could be considered clinically meaningful.ConclusionsThis analysis confirmed that the DSQ has acceptable distributional properties, test-retest reliability, construct validity, and ability to detect change. Therefore, the DSQ is a valid and reliable measure to assess the patient-reported symptom of dysphagia among adult and adolescent patients with EoE in the context of a clinical trial setting.
| S-EPMC11369371 | biostudies-literature
Project description:Perceived nose elongation resulting from vibratory stimulation to the bicep brachii tendon in the absence of visual input while the finger is touching the nose, known as the Pinocchio Illusion (PI), is used to investigate how afferent signals can contribute to aberrant top-down perception of body representation. The Pinocchio Illusion Questionnaire (PIQ) was developed to empirically quantify PI perception, allowing for external validation of the PI with psychologically relevant phenomenon. The current study (N = 60) examined the PIQ's test-retest reliability, internal consistency, factor structure, and correlations with self-reported interoceptive awareness and schizotypal traits. The PIQ demonstrated strong test-retest reliability and internal validity; however, a Principal Component Analysis did not yield a latent variable structure that distinguished PI-specific perceptual aberrations from unrelated or contradictory perceptual experiences. Additionally, decreased reports of PI-specific perceptual aberrations during two elicitations of the PI on the PIQ's open-ended free-response section (percent of sample endorsement = 5% (first elicitation); 8.3% (second elicitation)) compared to its 11-item section (endorsement of PI-specific items ranging 30-53.33% (first)]; 31.67-46.67% (second)) suggest that these responses may be heavily influenced by demand characteristics rather than accurately capturing PI perception. Therefore, further psychometric development of the PIQ and standardization of procedures to elicit the illusion are recommended.
| S-EPMC7351597 | biostudies-literature
Project description:Background: Nightmares are a widespread phenomenon. In comparison to the general population, they occur in mentally ill and especially in traumatized individuals with an increased frequency. Despite the high prevalence, there is no short questionnaire in the German language that is able to characterize nightmares, to differentiate between different nightmare types and to assess their impact on daytime functioning. Objective: The Hamburg Nightmare Questionnaire (HNQ) has been developed as a short self-rating instrument to fill this gap. Method: Psychometric characteristics of the HNQ were evaluated in a sample of 707 German soldiers passing through the standard diagnostics of the Center for Mental Health at the German Armed Forces Hospital Hamburg. Results: The results of this study show satisfactory psychometric characteristics as a sound factorial structure and adequate internal consistency for the HNQ as well as initial indications of the construct validity of its subscales. Conclusions: The HNQ is a reliable and economic tool for the assessment of posttraumatic nightmares in clinical as well as research settings.
| S-EPMC6461101 | biostudies-literature