The aim of this study was to assess the test-retest reliability of a measure of perceived general health by sex and age. The study analyzed data from the nationally representative Mini-Finland Health Survey of 8000 adults aged 30 and over. The subjects were invited to attend a personal health interview and a health examination in 1978-1980. Altogether 7217 persons participated. Perceived general health was measured at the personal health interview and in the self-administered questionnaire 1-6 weeks apart. The identical questions were: how would you assess your current health? The response alternatives were good, fairly good, intermediate, fairly poor, poor and cannot say. This study showed that among men and women unweighted agreement of the 'good-intermediate-poor' categorization of perceived health was around 70% and unweighted kappa-values were around 0.5. Only in the oldest age-group (75+) reliability declined below these levels. The fair or good reliability of perceived health observed in this study gives additional confidence for using this general measure of overall health status in future research.
To investigate the validity of self-reported birthweight among middle-aged and elderly women and to identify possible determinants of reporting accuracy.
The Danish Nurse Cohort Study (DNCS), a prospective risk factor and hormone therapy study.
Participants in the 1999 DNCS.
Self-reported exact and categorical birthweight data from the DNCS was compared with data from the Copenhagen School Health Records Register (CSHRR), which contains birthweight data.
Accuracy of self-reported birthweight expressed as mean difference with limits of agreement, sensitivity, specificity, and positive and negative predictive values (PPV and NPV).
Exact birthweight was available for 441 participants. The correlation coefficient was 0.83. The mean difference was -21 g and limits of agreement were -843 to 818 g. A total of 74% answered correctly within 250 g while 7% were more than 500 g in error. Categorical birthweight was available for 925 participants. A total of 87% reported the correct birthweight. Sensitivity and PPV were high for normal birthweight, whereas specificity and NPV were better for high and low birthweight (HBW and LBW). Multiple logistic regression analyses showed that HBW, LBW and being the daughter of a young mother decreased the accuracy of self-reported birthweight.
Self-reported birthweight is a valid measure of actual birthweight among middle-aged and elderly women. Due to the lower accuracy of HBW and LBW, studies of the association between birthweight and chronic disease may underestimate the true effect of these weights.
BACKGROUND: Collaboration between relatives and nurses in acute care settings is sparsely investigated, and that mostly from nurses' point of view. Feasible and valid instruments are needed for assessing collaboration, its prerequisites and outcome. OBJECTIVES: To develop and test an instrument to assess, from the relatives' perspective, collaboration between relatives of frail elderly patients and nurses in acute hospital wards, as well as prerequisites for, and outcome of, collaboration. DESIGN: Instrument development and psychometric testing. SETTING: Acute medical and geriatric wards. PARTICIPANTS: One hundred fifty-six relatives. Women constituted 74.8%, offspring 63.9% and spouses 20%, respectively. METHODS: A model for collaboration was developed and underpinned the development and construction of the instrument. Face and content validity was examined by relatives and an expert panel, before testing it among 156 relatives. Construct validity was assessed by principal component analysis and test for correlation between factors. Predictive validity was assessed by comparing factor scores with scores in outcome measures. Internal consistency was assessed by Cronbach's alpha for factors, item-to-total correlation and item-to-item correlation. Systematic internal dropout was investigated. RESULTS: A five-factor solution labelled "influence on decisions", "quality of contact with nurses", "trust and its prerequisites", "achieved information level" and "influence on discharge" showed Cronbach's alpha values between .83 and .94. Correlation between factors showed coefficients between .16 and .60. Item-to-total correlation values ranged between .34 and .83 and mean inter-item-correlation coefficients between .40 and .56. Predictive validity was indicated. Systematic internal dropout was related to higher age and lower educational level. CONCLUSION: The instrument was mainly valid and reliable. The instrument is, to our knowledge, the first of its kind and should be tested on larger samples in various cultural contexts. The feasibility of the instrument may benefit from a reduction of number of items.
ABSTRACTThe hidden nature of older adult mistreatment renders its detection in the domestic setting particularly challenging. A validated screening instrument that can provide a systematic assessment of risk factors can facilitate this detection. One such instrument, the "expanded Indicators of Abuse" tool, has been previously validated in the Hebrew language in a hospital setting. The present study has contributed to the validation of the "e-IOA" in an English-speaking community setting in Ontario, Canada. It consisted of two phases: (a) a content validity review and adaptation of the instrument by experts throughout Ontario, and (b) an inter-rater reliability assessment by home visiting nurses. The adaptation, the "Mistreatment of Older Adult Risk Factors" tool, offers a comprehensive tool for screening in the home setting. This instrument is significant to professional practice as practitioners working with older adults will be better equipped to assess for risk of mistreatment.
With the recent funding changes in health care services, more seniors with dementia are cared for in their homes and the nature of their condition puts them at higher risk for accidents and injuries.
The Safety Assessment Scale (SAS) was developed for use by community healthcare providers to evaluate and lower the risk of accidents, provide recommendations to family caregivers and enhance case management. Method. The scale was assessed in terms of the reliability as well as content, criterion and construct validity with 176 community-residing people with dementia in Quebec, Alberta and British Columbia. The Safety Assessment Scale was validated in French and English.
The SAS demonstrated an excellent test-retest (ICC=.91) and inter-rater (ICC=.88) reliability. Results for validity were also extremely good.
The scale is available in French and English. The short version of the SAS is a screening tool and the longer version provides an in-depth evaluation of safety and intervention planning. The SAS can be used by a variety of health care professionals who work with individuals who have dementia.
In 1875 registration of causes of death in Denmark was established by the National Board of Health, and annual statistics of death have since been published. Until 1970 the national statistics were based upon punched cards with data collected from the death certificates. Since then the register has been fully computerized and includes individual based data of all deaths occurring among all residents in Denmark dying in Denmark. Furthermore, a microfilm of all death certificates from 1943 and onward is kept in the National Board of Health. The Danish Institute for Clinical Epidemiology (DICE) has established a computerized register of individual records of deaths in Denmark from 1943 and onwards. No other country covers computerized individual based data of death registration for such a long period, now 54 years. This paper describes the history of the registers, the data sources and access to data, and the research based upon the registers, presenting some examples of research activities.
(a) To determine which of two values clarification exercises (VCE), based on theoretical decision rules used naturally by people, would be more helpful to patients making a treatment decision and (b) to evaluate the convergent validity of the most helpful VCE when part of a decision aid for the treatment of early-stage prostate cancer.
Two studies were completed. Study 1: Ninety community volunteers were assigned at random to one of three groups and all made a hypothetical treatment decision. Two groups received VCEs, one with a summary and one without, and the third was a control group. Study 2: In a multi-centre phase II trial, 69 patients used the decision aid that included the exercise ranked most helpful in Study 1. Decision aid assessments included the decisional conflict scale, treatment valuation assessment and regret.
Study 1: Most participants in each group ranked the VCE with the summary as most helpful. Study 2: VCE outputs, such as the size of the summary, were associated in predictable ways with the decision aid assessments.
The VCE ranked most helpful in Study 1 showed convergent validity with decision aid assessments.
With the interpretation of the VCE outputs now validated, a randomized controlled trial is required to determine if the exercise helps patients more than the aid without the exercise.
The authors wished to determine whether a simulator-based evaluation technique assessing clinical performance could demonstrate construct validity and determine the subjects' perception of realism of the evaluation process.
Research ethics board approval and informed consent were obtained. Subjects were 33 university-based anesthesiologists, 46 community-based anesthesiologists, 23 final-year anesthesiology residents, and 37 final-year medical students. The simulation involved patient evaluation, induction, and maintenance of anesthesia. Each problem was scored as follows: no response to the problem, score = 0; compensating intervention, score = 1; and corrective treatment, score = 2. Examples of problems included atelectasis, coronary ischemia, and hypothermia. After the simulation, participants rated the realism of their experience on a 10-point visual analog scale (VAS).
After testing for internal consistency, a seven-item scenario remained. The mean proportion scoring correct answers (out of 7) for each group was as follows: university-based anesthesiologists = 0.53, community-based anesthesiologists = 0.38, residents = 0.54, and medical students = 0.15. The overall group differences were significant (P