The aims of this study were to translate the International Skin Tear Advisory Panel (ISTAP) classification system for skin tears into Swedish and to validate the translated system. The research process consisted of two phases. Phase I involved the translation of the classification system, using the forward-back translation method, and a consensus survey. The survey dictated that the best Swedish translation for "skin tear" was "hudfliksskada." In Phase 2, the classification system was validated by health care professionals attending a wound care conference held in the spring of 2017 in Sweden. Thirty photographs representing three types of skin tear were presented to participants in random order. Participants were directed to classify the skin tear types in a data collection sheet. The results indicated a moderate level of agreement on classification of skin tears by type. Achieving moderate agreement for the ISTAP skin tear tool is an important milestone as it demonstrates the validity and reliability of the tool. Skin tear classification typing is a complex skill that requires training and time to develop. More education is required for all health care specialists on the classification of skin tears.
There is evidence that clinicians' pain attitudes and beliefs are associated with the pain beliefs and illness perceptions of their patients and furthermore influence their recommendations for activity and work to patients with back pain. The Pain Attitudes and Beliefs Scale (PABS) is a questionnaire designed to differentiate between biomedical and biopsychosocial pain attitudes among health care providers regarding common low back pain. The original version had 36 items, and several shorter versions have been developed. Concern has been raised over the PABS' internal construct validity because of low internal consistency and low explained variance. The aim of this study was to examine and improve the scale's measurement properties and item performance.
A convenience sample of 667 Norwegian physiotherapists provided data for Rasch analysis. The biomedical and biopsychosocial subscales of the PABS were examined for unidimensionality, local response independency, invariance, response category function and targeting of persons and items. Reliability was measured with the person separation index (PSI). Items originally excluded by the developers of the scale because of skewness were re-introduced in a second analysis.
Our analysis suggested that both subscales required removal of several psychometrically redundant and misfitting items to satisfy the requirements of the Rasch measurement model. Most biopsychosocial items needed revision of their scoring structure. Furthermore, we identified two items originally excluded because of skewness that improved the reliability of the subscales after re-introduction. The ultimate result was two strictly unidimensional subscales, each consisting of seven items, with invariant item ordering and free from any form of misfit. The unidimensionality implies that summation of items to valid total scores is justified. Transformation tables are provided to convert raw ordinal scores to unbiased interval-level scores. Both subscales were adequately targeted at the ability level of our physiotherapist population. Reliability of the biomedical subscale as measured with the PSI was 0.69. A low PSI of 0.64 for the biopsychosocial subscale indicated limitations with regard to its discriminative ability.
Rasch analysis produced an improved Norwegian version of the PABS which represents true (fundamental) measurement of clinicians' biomedical and biopsychosocial treatment orientation. However, researchers should be aware of the low discriminative ability of the biopsychosocial subscale when analyzing differences and effect changes.
The study presents a revised PABS that provides interval-level measurement of clinicians' pain beliefs. The revision allows for confident use of parametric statistical analysis. Further examination of discriminative validity is required.
Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland. Electronic address: email@example.com.
Chronic pain causes suffering for affected individuals and incurs costs to society through work disability. Interventions based on early screening of psychological risk factors for chronic pain using screening tools such as the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) have been found to reduce work absenteeism and health care visits and increase perceived health. The aim of the current study was to translate the ÖMPSQ into Finnish and test its validity and reliability in a patient sample.
The ÖMPSQ was forward-backward translated and cross-culturally adapted, and applied to our study population (n=69), the members of which had been referred to the Department of Physical and Rehabilitation Medicine of Oulu University Hospital from primary health care centres in Northern Finland due to chronic low back pain. The patients answered the ÖMPSQ two weeks before the hospital visit, and the follow-up questionnaire either during the hospital visit, or after by mail. The reliability of the ÖMPSQ was evaluated using intraclass correlation coefficients (ICC). Factor analysis was used to group items of the ÖMPSQ, and internal consistency between the items was determined by calculating Cronbach's alphas.
The cross-cultural adaptation revealed only minor semantic and cultural differences. Measurements showed reliability as moderate to nearly perfect for all of the ÖMPSQ items (ICC values ranged from 0.59 to 0.96). Items loaded into five different factors: disability, psychological symptoms, pain, fear avoidance, and work. All except one (work) showed acceptable internal consistency. The ÖMPSQ score was positively associated with both intensity of pain and the Oswestry Disability Index.
The reliability and construct validity of the Finnish version of the ÖMPSQ were good. The predictive ability of the ÖMPSQ in the Finnish population should be evaluated in further studies.
Linguistic adaptation of the Russian version of the Short-form McGill Pain Questionnaire-2 (SF-MPQ-2), which is conceptually equivalent to the original questionnaire.
The adaptation of the Russian version of SF-MPQ-2 was performed in accordance to established rules in several stages by two independent translators with the development of a consensus Russian version and its back translation by two independent translators and development of a consensus English version. The final Russian SF-MPQ-2 version was then created.
The Russian version of the Short-form McGill Pain Questionnaire-2 (SF-MPQ-2-RU) was generated based on the established rules. This version was legally registered by the right holder - Mapi Research Trust and recommended for research in the Russian Federation.
Low back pain (LBP) is a debilitating problem worldwide causing disability and reducing quality of life. The Fear Avoidance Beliefs Questionnaire (FABQ) was developed on the basis of the assumption that fear-avoidance beliefs play a major role in LBP-related disability. It comprises 16 items scored by the patient and includes sub-scores for fear-avoidance beliefs regarding work and physical activity. This study aimed to translate and validate the Finnish version of the FABQ and to measure its properties among Finnish patients with LBP.
A forward-backward translation procedure was used based on modified recommended guidelines. The FABQ was applied to 66 Finnish patients with LBP. Patients answered the FABQ at baseline and again approximately two weeks later. The test-re-test reliability between the baseline and follow-up FABQ was evaluated by calculating intraclass correlation coefficients (ICC). Internal consistency between the items within total and sub-scores was evaluated by calculating Cronbach's alpha. The items of the baseline FABQ were grouped using factor analysis and the correlations between the FABQ, pain intensity in visual analogue scale (VAS) and Oswestry Disability Index (ODI) were assessed using linear regression analysis.
The Finnish version of the FABQ was successfully adapted. The mean age of patients was 46. Almost all patients (97%) reported LBP, most patients (76%) had chronic pain lasting more than 3 months and the mean intensity of LBP was 58mm on VAS. The follow-up time between the first and second questionnaire ranged from 2 days to 59 days with the median of 16 days. The ICC value for reliability between the baseline and follow-up questionnaires was excellent for the total score (0.91) and work sub-score (0.89), and good for the physical activity sub-score (0.73). The items regarding work showed high or excellent reliability throughout, with ICC values ranging from 0.63 to 0.89. The ICC values for the items related to physical activity ranged from 0.43 to 0.66, displaying moderate to good reliability. Cronbach's alpha for internal consistency was excellent for the total score (0.92) and work (0.89), and good for physical activity (0.71). The best factor analysis solution yielded three factors characterized by the fear that pain aggravates due to (1) work or (2) physical activity, and (3) fear-avoidance beliefs concerning work. Higher total FABQ score was associated significantly with higher VAS (p-value 0.021) and ODI (
The Care Process Self-Evaluation Tool (CPSET) assesses key characteristics of well-organised care processes in hospitals from an interprofessional team perspective. The present study investigated the psychometric properties of the CPSET in terms of factor structure, convergent and discriminant validity, and reliability in Norwegian language and context. After a pilot test, the Norwegian version of the questionnaire was administered as a web form to 501 health professionals in public general hospitals and mental health specialist services; 301 completed forms (response rate 60%) were returned, and 268 (54%) forms representing 27 care processes (19 from somatic care and 8 from mental healthcare) were included in the valid sample. A confirmatory factor analysis (CFA) confirmed the original five-factor structure. All model fit indices, including the standardised root mean square residual (SRMR), which is independent of the ?2-test, met the criteria for an acceptable model fit. Internal consistencies within sub-scales as measured by Cronbach's alpha were high (range 0.83-0.94). As expected, some redundancy between factors existed (in particular among the PO (Patient-focused organisation), COR (Coordination of the care process), COM (Communication with patient and family), and PO (Follow-up of the care process) factors). In conclusion, the Norwegian CPSET scale showed acceptable psychometric properties in terms of convergent validity and reliability, and fit indices from the CFA confirmed the original factor structure. Based on these findings, we recommend the Norwegian version of the CPSET for use in the assessment of interprofessional teamwork in care processes in specialist healthcare.
To investigate whether the daily workload per nurse (Oulu Patient Classification (OPCq)/nurse) as measured by the RAFAELA system correlates with different types of patient safety incidents and with patient mortality, and to compare the results with regressions based on the standard patients/nurse measure.
We obtained data from 36 units from four Finnish hospitals. One was a tertiary acute care hospital, and the three others were secondary acute care hospitals.
Patients' nursing intensity (249?123 classifications), nursing resources, patient safety incidents and patient mortality were collected on a daily basis during 1?year, corresponding to 12?475 data points. Associations between OPC/nurse and patient safety incidents or mortality were estimated using unadjusted logistic regression models, and models that adjusted for ward-specific effects, and effects of day of the week, holiday and season.
Main outcome measures were patient safety incidents and death of a patient.
When OPC/nurse was above the assumed optimal level, the adjusted odds for a patient safety incident were 1.24 (95% CI 1.08 to 1.42) that of the assumed optimal level, and 0.79 (95% CI 0.67 to 0.93) if it was below the assumed optimal level. Corresponding estimates for patient mortality were 1.43 (95% CI 1.18 to 1.73) and 0.78 (95% CI 0.60 to 1.00), respectively. As compared with the patients/nurse classification, models estimated on basis of the RAFAELA classification system generally provided larger effect sizes, greater statistical power and better model fit, although the difference was not very large. Net benefits as calculated on the basis of decision analysis did not provide any clear evidence on which measure to prefer.
We have demonstrated an association between daily workload per nurse and patient safety incidents and mortality. Current findings need to be replicated by future studies.
Personality is generally considered to be biologically founded in temperament, and temperamental qualities have proven to be relatively stable across childhood and into adulthood (Caspi, Roberts & Shiner, ). Temperament predicts important developmental outcomes such as academic performance (Muris, ), and social functioning (Eisenberg, Fabes, Guthrie & Reiser, ), and it has also been found to be strongly related to the etiology and maintenance of internalizing and externalizing psychopathology in children (Muris, Meesters & Blijlevens, ; Nigg, ). To allow for the possibility of making early interventions, identification of potential risk factors (such as temperamental dispositions) is of great importance (Rettew & McKee, ). As temperament is multidimensional and has many different manifestations, parents and teachers are valuable sources in providing information about children's temperament (Rothbart & Bates, ; Tackett, Slobodskaya, Mar et al., ), and caregiver questionnaires are frequently used in child personality research. However, such questionnaires are only useful if their reliability and validity have been established. The aim of the present study was to examine the psychometric properties of the Temperament in Middle Childhood Questionnaire (TMCQ; Simonds, Kieras, Rueda & Rothbart, ), which focuses specifically on the ages between 7 and 11 years. The TMCQ is the least validated of the Rothbart measures, and although reliability data have been presented, together with some validity data, for a computerized self-report version of the questionnaire (Simonds & Rothbart, ), information about the reliability and validity for the caregiver version is scant. In the present paper, we report such data for a Swedish sample.
The Texas Revised Inventory of Grief (TRIG) was developed to measure the intensity of grief after the death of a close person. It consists of two scales: TRIG I (past behaviors) and TRIG II (present feelings). Because of inconsistencies in previous validations, the instrument needs to be further validated, hence the aim of this study was to evaluate the psychometric properties of the TRIG in a sample of bereaved family caregivers in Sweden. The TRIG was translated to Swedish according to standard principles, and 129 bereaved family caregivers completed the questionnaire. Parallel analysis was used to decide the number of factors to extract, followed by confirmatory factor analysis. An ordinal version of Cronbach's alpha was used to evaluate the internal consistency of the scales. Construct validity was tested against the Hospital Anxiety and Depression Scale (HADS). The factor analyses resulted in one factor being retained for both scales. The internal consistency was excellent (a?>?0.9) for both scales. Construct validity was supported by strong correlations between TRIG I and TRIG II as well as moderate correlations between the TRIG scales and HADS. In conclusion, the TRIG has sound psychometric qualities and the two scales should be treated as unidimensional measures of grief. Hence, the instrument is suited to be used in the context of palliative care.
Previous studies of the reproducibility of self-reported age at menarche have been limited because of small study samples, short follow-up and the limited age span of the women included.
The present study assessed the reproducibility of age at menarche in 6731 women with a wide variation of age when giving the information about age at menarche. The women reported age at menarche in a self-administered questionnaire, both in 1986-1987 and 1994-1995. They were all residents of Tromsø, Norway, and aged 25-73 in 1994-1995. In order to investigate the agreement between self-reported age at menarche at the two points in time, Pearson's correlation coefficient was applied to assess the linear correlation between the reported menarcheal age at the two occasions. Analyses were stratified for age. A Bland-Altman plot was produced and limits of agreement computed.
We found a high correlation and a strong agreement between self-reported age at menarche in 1986-1987 and 1994-1995. The overall Pearson's correlation coefficient was 0.84 and was not attenuated by increasing age of the women. The Bland-Altman plot showed a strong agreement in self-reported age at menarche. The mean difference between self-reported age at menarche was 0.01 years with limits of agreement -1.52 to 1.54.
We found high reproducibility of self-reported age at menarche. The mean menarcheal age in the two surveys was identical (13.2 years) with 95% of the women reporting the same age at menarche or with a difference of 1 year. Only 0.7% of the women reported age at menarche with a difference of more than 2 years in 1986-1987 and 1994-1995.
Cites: Dev Psychol. 2013 Jun;49(6):1187-93 PMID 22889389
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