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- Go to article: Lessons Learned in Instrument Pilot Testing With Mexican American Caregivers of Elders
Given the fast-growing Mexican American (MA) population, it is common for investigators to be pressured into using Spanish translated instruments developed for English-speaking populations. However, these translated instruments may have limited relevance for data collection without adequate assessment and vetting. The purpose of this paper is to present lessons learned from the pilot testing of instruments designed for use with Mexican Americans. Pilot testing of two instruments was conducted with 22 Mexican American family caregivers of older adults. Issues that emerged were classified into three categories—instrumentation, methodology, and demographic data. Within the area of instrumentation, six issues were identified—level of abstraction, concreteness, pronoun use, clarity, exclusiveness, and response format. Methodological concerns were focused on test–retest administration and inclusion criteria. Issues within the demographic data were concerned with marital status, country of birth, household size and income, and validity of self-rated scales. By addressing those concerns, investigators may be more likely to have culturally sensitive measures and greater generalization to relevant MA populations.
Self-efficacy is an important determinant of health behavior that can be targeted for intervention. Little effort has been given to the development of valid measures for self-efficacy with medication taking for adherence research. The purpose of this study was to determine the criterion validity of the Long-Term Medication Behavior Self-Efficacy Scale (LTMBSES). Individual patient data from 6 existing adherence studies in transplant, hyperlipidemia, and AIDS/HIV patients (n = 1021) were pooled. Validity was determined by assessing the relation between the LTMBSES score and medication adherence—both self-reported and electronically monitored. A weak relationship was found between the LTMBSES score and adherence, which can possibly be attributed to a ceiling effect, caused by a too homogeneous population and/or a failure of the scale to challenge patients. Generalized Estimating Equations revealed that the total average self-efficacy score predicted reported medication adherence (p < .0001). The Receiver Operating Characteristic curve revealed the area under the curve was 0.67, indicating a significant (p < .0001), but poor predictive capability. Evidence for criterion validity of the Long-Term Medication Behavior Self-Efficacy Scale is not yet convincing. Future research should focus on: (1) validation in a population with a more heterogenous level of adherence, and (2) making the scale more challenging by referring to “always taking the medication without exception.”
- Go to article: The Maturation Index of Colostrum and Milk (MICAM): A Measurement of Breast Milk Maturation
A biological marker, the Maturation Index of Colostrum and Milk (MIC AM), was developed using filter paper chromatography. The MICAM consists of five patterns used to measure the individual rate of breast milk maturation among mothers. This article documents the biological basis of MICAM patterns as a gradual breakdown of an emulsion of breast milk that is dependent on the ratio of sterols plus phospholipids to fat content of the milk. Frequencies of MICAM patterns by day, timing of the milk collection, and inter-rater reliability are addressed and the construct validity is explored.
This was a partial replication of the original tool development reported by Humenick in 1987. In both studies, the variables of timing of breast-feeding initiation, frequency, and cumulative length of breast-feeding episodes were significantly correlated as predictors of early milk maturation as measured by the MICAM. Milk maturation rate was also significantly correlated as a predictor of infant weight gain, weeks of sustained breast-feeding, and maternal-infant breast-feeding satisfaction. The MICAM can be used as a clinical screening tool to assess the progress of milk maturation in cases where breast-feeding has had a difficult or delayed initiation, and to evaluate interventions designed to support lactation.
Background and Purpose: The purpose of this study was to test the psychometric properties of the Osteoporosis Knowledge Test (OKT) revised to incorporate recent evidence-based recommendations for bone health. Methods: The revised OKT was tested with 866 participants (mean age = 62.8 years ± 8.5 years) in an online bone health study. Results: Based on Rasch analysis, there was evidence of internal consistency with an item separation index of 12.68 and a reliability score of .98. The person separation index was 2.06 with a reliability score of .81. The INFIT and OUTFIT mean-square statistics for items on both subscales all demonstrated good fit ranging from 0.71 to 1.40, except for 2 items that had low OUTFIT statistics. Conclusions: The revised OKT provides sufficient reliability and construct validity.
- Go to article: Psychometric Evaluation of a Tool for Assessment of Clinical Development in Newly Licensed Registered Nurses
Psychometric Evaluation of a Tool for Assessment of Clinical Development in Newly Licensed Registered Nurses
Background and Purpose
For effective evaluation of clinical development, established psychometric properties of reliability and validity are essential. The Clinical Development Assessment (CDA) tool was developed within a 12-month pediatric nurse residency program. Benner's novice-to-expert model framed the development of the CDA.
Data from 129 nurse residents and their preceptors were used to evaluate internal consistency reliability and face, content, and construct validity. Nine elements were assigned a six-point Likert scale scored as (a) unsafe, (b) novice, (c) advanced beginner, (d) competent, (e) proficient, and (f) expert.
Moderately strong reliability was found. Using exploratory factor analysis, a single factor accounted for 68% of the variance in clinical development. Face and content validity were confirmed.
This study identified a brief, valid, and reliable tool to evaluate clinical development in newly licensed registered nurses.
- Go to article: Psychometric Testing of the Sidani and Doran Therapeutic Self-Care Scale in a Home Health Care Population
Psychometric Testing of the Sidani and Doran Therapeutic Self-Care Scale in a Home Health Care Population
Background and Purpose: Self-care is a central goal of home health (HH) nursing care. The study purpose was to assess psychometric performance of the Therapeutic Self-Care Scale (TSCS) in a U.S. HH population. Methods: TSCS reliability was assessed with Cronbach’s alpha and test–retest analyses (n = 59). Convergent validity testing and principal components analysis (PCA) were performed. Results: After elimination of 2 items, internal consistency reliability was acceptable (α = .804) and test–retest reliability was high (intraclass correlation = .94; p < .001). Convergent validity analyses were inconclusive. PCA found 2 underlying dimensions consistent with a conceptual difference between self-care and self-management. Conclusions: A valid, reliable measure of self-care/management would be useful for measurement of HH nursing outcomes. The TSCS holds promise but needs further refinement before it can serve this purpose.
- Go to article: Self-as-Doer for Diabetes: Development and Validation of a Diabetes-Specific Measure of Doer Identification
Self-as-Doer for Diabetes: Development and Validation of a Diabetes-Specific Measure of Doer Identification
Background: The purpose of this study was to develop and validate a scale to measure the level of self-care behavior “doer identity” in persons with diabetes. Methods: Persons with diabetes (N = 355) completed questionnaires assessing self-as-doer identity and other related constructs. Principle components and parallel analyses and tests of reliability and validity were performed. Results: A 7 factor solution explained 55.24% of the total variance on behaviors. Cronbach’s alpha was .93 for the overall scale. Extracted components moderately correlated with one another and theoretically similar constructs. Self-as-doer identity significantly predicted all self-care behaviors (except for blood glucose monitoring) and glycemic control over and above related variables for persons with type 1 diabetes. Self-as-doer identity also predicted diet behaviors for persons with type 2 diabetes. Conclusions: Evidence for a reliable and valid factor structure of the Self-as-doer-Diabetes measure was demonstrated.