-
Frontiers in Psychiatry 2023Moral injury, predominantly studied in military populations, has garnered increased attention in the healthcare setting, in large part due to the psychological and...
INTRODUCTION
Moral injury, predominantly studied in military populations, has garnered increased attention in the healthcare setting, in large part due to the psychological and emotional consequences of the COVID-19 pandemic. The measurement of moral injury with instrumentation adapted from military settings and validated by frontline healthcare personnel is essential to assess prevalence and guide intervention. This study aimed to validate the Moral Injury Outcome Scale (MIOS) in the population of acute care.
METHODS
A sample of 309 acute care nurses completed surveys regarding moral injury, depression, anxiety, burnout, professional fulfillment, spiritual wellbeing, and post-traumatic stress disorder symptoms. Confirmatory factor analysis was conducted as well as an assessment of reliability and validity.
RESULTS
The internal consistency of the 14-item MIOS was 0.89. The scale demonstrated significant convergent and discriminant validity, and the test of construct validity confirmed the two-factor structure of shame and trust violations in this clinical population. Regression analysis indicated age, race, and marital status-related differences in the experience of moral injury.
DISCUSSION
The MIOS is valid and reliable in acute care nursing populations and demonstrates sound psychometric properties. Scores among nurses diverge from those of military personnel in areas that may inform distinctions in interventions to address moral injury in these populations.
PubMed: 38094593
DOI: 10.3389/fpsyt.2023.1279255 -
BMC Geriatrics Jun 2022The Dyspnoea-12 (D12) and Multidimensional dyspnea profile (MDP) are commonly used instruments for assessing multiple dimensions of breathlessness but have not been...
BACKGROUND
The Dyspnoea-12 (D12) and Multidimensional dyspnea profile (MDP) are commonly used instruments for assessing multiple dimensions of breathlessness but have not been validated in older people in the population. The aim of this study was to validate the D12 and MDP in 73-years old men in terms of the instruments' underlying factor structures, internal consistency, and validity.
METHODS
A postal survey was sent out to a population sample of 73-years old men (n = 1,193) in southern Sweden. The two-factor structures were evaluated with confirmatory factor analysis, internal consistency with Cronbach's alpha, and validity using Pearson´s correlations with validated scales of breathlessness, anxiety, depression, fatigue, physical/mental quality of life, body mass index (BMI), and cardiorespiratory disease.
RESULTS
A total 684 men were included. Respiratory and cardiovascular disease were reported by 17% and 38%, respectively. For D12 and MDP, the proposed two-factor structure was not fully confirmed in this population. Internal consistency was excellent for all D12 and MDP domain scores (Cronbach's alpha scores > 0.92), and the instruments' domains showed concurrent validity with other breathlessness scales, and discriminant validity with anxiety, depression, physical/mental quality of life, BMI, and cardiorespiratory disease.
CONCLUSIONS
In a population sample of 73-years old men, the D12 and MDP had good psychometrical properties in terms of reliability and validity, which supports that the instruments are valid for use in population studies of older men.
Topics: Aged; Dyspnea; Humans; Male; Psychometrics; Quality of Life; Reproducibility of Results; Sweden
PubMed: 35655151
DOI: 10.1186/s12877-022-03166-5 -
Insights Into Imaging Aug 2023To develop and validate European entrustable professional activities (EPAs) for sub-specialised hepatobiliary and gastrointestinal (HB/GI) diagnostic imaging.
OBJECTIVES
To develop and validate European entrustable professional activities (EPAs) for sub-specialised hepatobiliary and gastrointestinal (HB/GI) diagnostic imaging.
MATERIALS AND METHODS
Both European Society of Radiology and national curricula in HB/GI diagnostic radiology were thoroughly reviewed, resulting in preliminary EPAs drafted by a pilot group of expert radiologists in 2 different countries. Each EPA was fully described with 7 components (Specification/limitations; Potential risks of failing; Relevant domains of competence; Required experience, knowledge, skills, attitude and behaviour; Assessment information sources to assess progress and ground a summative entrustment decision; Entrustment for which level of supervision is to be reached; and Expiration date). The modified Delphi method with 3 Delphi rounds was chosen for validation. Content validity index (CVI) and median values were used for validation.
RESULTS
There were 15 preliminary EPAs, some of them divided according to 2 levels: resident and fellow level. The 37 members of the Delphi group were based in 2 different European countries with a background experience of 10 represented countries. Subsequent to the first Delphi round, 6 EPAs were accepted (CVI ≥ 0.8, median ≥ 4), 6 needed major revisions (CVI 0.7-0.79, median ≥ 4), 3 were rejected (CVI < 0.7) and 1 was added. After the second Delphi round, both the 6 revised EPAs and the additional one met the validation criteria (CVI ≥ 0.8, median ≥ 4). Finally, 13 EPAs were validated during the 3 Delphi round with an agreement percentage of 95-100%.
CONCLUSION
This study creates and validates EPAs for sub-specialised HB/GI diagnostic imaging.
CRITICAL RELEVANCE STATEMENT
Thirteen EPAs for sub-specialised hepatobiliary and gastrointestinal diagnostic imaging were created with a strong methodology, and as a first example set in sub-specialised diagnostic imaging, they provide a template for others to be created.
KEY POINTS
• The competence-based teaching in medical studies has recently been reintroduced through EPAs. • Thirteen EPAs have been developed for hepatobiliary and gastrointestinal sub-specialised diagnostic imaging. • These EPAs were validated using a Delphi modified method and provide a template for other to be created.
PubMed: 37644337
DOI: 10.1186/s13244-023-01482-x -
BMC Oral Health Jun 2022This study aimed to develop a new chewing problem directory (CPD) and validate it with oral health indicators such as total occlusion force, number of natural and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
This study aimed to develop a new chewing problem directory (CPD) and validate it with oral health indicators such as total occlusion force, number of natural and rehabilitated teeth (NRT), NRT posterior, natural teeth, natural teeth posterior, and dental status among Korean elders.
BACKGROUND
Chewing problem is the main oral health problem in elders. However, there has been no validated tool using both subjective and objective assessment of chewing problem.
SUBJECTS AND METHODS
A total of 537 participants aged 65 years or more were randomly assigned into 2 subsamples: developing sample (n = 260) for developing and internally validating the new CPD as the 1st stage and confirmation sample (n = 277) for confirming validation of CPD as the 2nd stage. CPD was developed using three subjective questionnaires (general eating, chewing nuts, and chewing meat problem) and objective NRT. Periodontitis, age, sex, education, smoking, alcohol drinking, metabolic syndrome, and frailty were considered as confounders. Following the development of CPD, CPD was validated using multiple multivariable logistic regression after controlling for confounders in confirmation sample and total sample.
RESULTS
The Cronbach's alpha value for three subjective questionnaires of CPD was 0.87. Among oral health indicators, NRT (0-28) showed the highest impact association with subjective chewing problem score (partial r = - 0.276). The chewing problem from the new CPD was associated with all items of oral health indicators. The prevalence of chewing problems by CPD was 57.7% in developing sample. Elders with NRT ≤ 24, compared with those with NRT ≥ 25, showed the highest impact on chewing problems by new CPD (Odds Ratio = 7.3 in the confirmation sample and 5.04 in the total sample, p < 0.05) among oral health indicators.
CONCLUSION
This new CPD was developed as a valid tool to evaluate the chewing problem for Korean elders in dental clinics and community-based settings.
Topics: Aged; Humans; Mastication; Mouth, Edentulous; Oral Health; Patient Acuity; Republic of Korea; Surveys and Questionnaires
PubMed: 35752793
DOI: 10.1186/s12903-022-02290-3 -
Journal of Clinical Epidemiology May 2022To identify and critically appraise risk prediction models for living donor solid organ transplant counselling. (Review)
Review
OBJECTIVE
To identify and critically appraise risk prediction models for living donor solid organ transplant counselling.
STUDY DESIGN AND SETTING
We systematically reviewed articles describing the development or validation of prognostic risk prediction models about living donor solid organ (kidney and liver) transplantation indexed in Medline until April 4, 2021. Models were eligible if intended to predict, at transplant counselling, any outcome occurring after transplantation or donation in recipients or donors. Duplicate study selection, data extraction, assessment for risk of bias and quality of reporting was done using the CHARMS checklist, PRISMA recommendations, PROBAST tool, and TRIPOD Statement.
RESULTS
We screened 4691 titles and included 49 studies describing 68 models (35 kidney, 33 liver transplantation). We identified 49 new risk prediction models and 19 external validations of existing models. Most models predicted recipients outcomes (n = 38, 75%), e.g., kidney graft loss (29%), or mortality of liver transplant recipients (55%). Many new models (n = 46, 94%) and external validations (n = 17, 89%) had a high risk of bias because of methodological weaknesses. The quality of reporting was generally poor.
CONCLUSION
We advise against applying poorly developed, reported, or validated prediction models. Future studies could validate or update the few identified methodologically appropriate models.
Topics: Humans; Kidney Transplantation; Prognosis; Tissue Donors
PubMed: 35124188
DOI: 10.1016/j.jclinepi.2022.01.025 -
Neuropsychiatric Disease and Treatment 2022Cognition is one of the most complex functions of the human brain, and major neurocognitive disorders affect this function causing a wide array of problems in an...
BACKGROUND
Cognition is one of the most complex functions of the human brain, and major neurocognitive disorders affect this function causing a wide array of problems in an individual's life. Screening for major neurocognitive disorders can be helpful in designing and implementing early interventions.
PURPOSE
This study was designed to assess the reliability and validity of the Montreal Cognitive Assessment (MoCA) tool to detect major neurocognitive disorders among older people in Ethiopia.
METHODS
One hundred and sixteen randomly selected older adults in Ethiopia were involved in a cross-sectional study. The Diagnostic and Statistical Manual of Mental Disorders criteria for major neurocognitive disorders was used as a gold standard. Data were analyzed using STATA v16 statistical software. Receiver operating curve analysis was performed, and inter-rater, internal consistency reliabilities, content, criterion and construct validities were determined. Statistically significance was declared at a p-value of <0.05.
RESULTS
The study had a 100% response rate. The mean age of the study participants was 69.87 ± 7.8. The inter-rater reliability value was 0.96, and Cronbach's alpha was 0.79. The optimal cutoff value was ≤21, and Montreal Cognitive Assessment has an area under curve value of 0.89. The sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values of MoCA are 87.18%, 74.03%, 3.35, 0.17, 63%, and 91.9%, respectively. The tool also has good concurrent and construct validities.
CONCLUSION
The Montreal Cognitive Assessment tool was a reliable and valid tool to detect major neurocognitive disorder. It can be incorporated into the clinical and research practices in developing countries.
PubMed: 36035074
DOI: 10.2147/NDT.S377430 -
Cureus Oct 2020Background and Objective: Carpal tunnel syndrome (CTS) is the most common mononeuropathy in humans. Despite the continuous improvement of diagnostic and treatment...
UNLABELLED
Background and Objective: Carpal tunnel syndrome (CTS) is the most common mononeuropathy in humans. Despite the continuous improvement of diagnostic and treatment methods, difficulties remain in the evaluation and quantification of such symptoms as pain, paresthesias, hypesthesia, and hyperesthesia. Numerous tests and questionnaires have been developed for patients with upper limb disease, but the most specific for CTS and the most commonly used is the Boston Carpal Tunnel Questionnaire (BCTQ). BCTQ has been translated and validated for use in many languages, but there is no valid version in Bulgarian yet. The purpose of this work is to create and validate a Bulgarian version of BCTQ, with a recommendation for its use in Bulgarian patients.
METHODS
The process was divided into two parts. The first part included a translation and a cultural-linguistic adaptation of the Bulgarian version of BCTQ. In the second part, verification of the psychometric properties of the Bulgarian BCTQ, we investigated the reliability, validity and responsiveness of the Bulgarian version of BCTQ. We evaluated BCTQ's construct validity by comparing its results with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The study was performed on a group of 64 patients with a confirmed diagnosis of CTS. All patients were evaluated using the BCTQ and DASH questionnaires. A subgroup of 26 patients underwent open surgical decompression of the carpal canal using a mini-incision technique. The subgroup was evaluated through BCTQ and DASH questionnaires preoperatively and through BCTQ postoperatively at the third month after the intervention.
RESULTS
In the first part of the study, the final version of the questionnaire was presented. Cronbach's alpha coefficient was 0.88 for the Symptom Severity Scale (SSS) and 0.87 for the Functional Status Scale (FSS). The reproducibility of scores showed an extremely high degree of correlation between the two consecutive BCTQ scores at one-week interval (SSS r=0.99, p<0.0001; FSS r=1, p<0.0001). The criterion validity of the Bulgarian version of BCTQ revealed a strong correlation between the results of the BCTQ and the DASH questionnaires. (SSS r(62)=0.569, p<0.00001; FSS r(62)=0.605, p<0.00001). There was a statistically significant decrease in BCTQ results after surgery for both the SSS (t=-9.43, p<0.00001) and the FSS (t=-9.82, p<0.00001).
CONCLUSION
Our study created a translated and culturally adapted version of BCTQ. The Bulgarian version of BCTQ is reliable, valid, and responsive for measuring symptoms and functional deficits in patients with CTS.
PubMed: 33194469
DOI: 10.7759/cureus.10901 -
European Journal of Midwifery 2023Using validated and reliable instruments to examine women's birth experiences is important to ensure respectful care. There is a lack of validated instruments for...
INTRODUCTION
Using validated and reliable instruments to examine women's birth experiences is important to ensure respectful care. There is a lack of validated instruments for evaluating childbirth care in the Slovak context. In this study, we aimed to adapt and validate the childbirth experience questionnaire (CEQ) in Slovakia (CEQ-SK).
METHOD
The CEQ-SK was developed and modified from the English version of the CEQ/CEQ2. Face validity was tested in two pre-tests. A convenience sample, recruited through social media, included 286 women who had given birth within the last six months. Reliability was assessed using Cronbach's alpha. Construct and discriminant validity was assessed by exploratory factor analysis and known-group comparison.
RESULTS
The exploratory factor analysis revealed a three-dimensional structure, explaining 63.3% of the total variance. The factors were labelled 'Own capacity', 'Professional support' and 'Decision making'. No items were excluded. Internal consistency was demonstrated with an overall Cronbach's alpha of 0.94 for the total scale. Primiparous women, women who had an emergency cesarean section, and women who had been exposed to the Kristeller manoeuvre had a lower overall score on the CEQ-SK compared to parous women, women having a vaginal birth and women not exposed to the Kristeller manoeuvre.
CONCLUSION
The CEQ-SK was found to be a valid and reliable tool for evaluating childbirth experience in Slovakia. The original CEQ is a four-dimensional questionnaire; however, factor analysis showed a three-dimensional structure in the Slovak sample. This needs to be taken into consideration when comparing the results from the CEQ-SK with studies that use the four-dimensional structure.
PubMed: 36926447
DOI: 10.18332/ejm/160973 -
Global Public Health Dec 2022Sex workers face different types of sex work-related stigma, which may include anticipated, perceived, experienced, or internalized stigma. Sex work stigma can...
Sex workers face different types of sex work-related stigma, which may include anticipated, perceived, experienced, or internalized stigma. Sex work stigma can discourage health care seeking and hamper STI and HIV prevention and treatment efforts. There is a paucity of validated sex work-related stigma measures, and this limits the ability to study the stigma associated with sex work. A cross-sectional survey was conducted that measured sex work-related stigma among male and female sex workers in Kenya (N = 729). We examined the construct validity and reliability of the anticipated stigma items to establish a conceptually and statistically valid scale. Our analysis supported a 15-item scale measuring five anticipated sex work stigma domains: gossip and verbal abuse from family; gossip and verbal abuse from healthcare workers; gossip and verbal abuse from friends and community; physical abuse; and exclusion. The scale demonstrated good face, content, and construct validity. Reliability was good for all subscales and the overall scale. The scale demonstrated good model fit statistics and good standardized factor loadings. The availability of valid and reliable stigma measures will enhance efforts to characterize and address stigma among sex workers and ultimately support the protection, health and well-being of this vulnerable population.
Topics: Humans; Male; Female; Sex Workers; Kenya; Sex Work; Reproducibility of Results; Cross-Sectional Studies; HIV Infections; Social Stigma
PubMed: 35938397
DOI: 10.1080/17441692.2022.2105377 -
Validation and validity of diagnoses in the General Practice Research Database: a systematic review.British Journal of Clinical Pharmacology Jan 2010To investigate the range of methods used to validate diagnoses in the General Practice Research Database (GPRD), to summarize findings and to assess the quality of these... (Review)
Review
AIMS
To investigate the range of methods used to validate diagnoses in the General Practice Research Database (GPRD), to summarize findings and to assess the quality of these validations.
METHODS
A systematic literature review was performed by searching PubMed and Embase for publications using GPRD data published between 1987 and April 2008. Additional publications were identified from conference proceedings, back issues of relevant journals, bibliographies of retrieved publications and relevant websites. Publications that reported attempts to validate disease diagnoses recorded in the GPRD were included.
RESULTS
We identified 212 publications, often validating more than one diagnosis. In total, 357 validations investigating 183 different diagnoses met our inclusion criteria. Of these, 303 (85%) utilized data from outside the GPRD to validate diagnoses. The remainder utilized only data recorded in the database. The median proportion of cases with a confirmed diagnosis was 89% (range 24-100%). Details of validation methods and results were often incomplete.
CONCLUSIONS
A number of methods have been used to assess validity. Overall, estimates of validity were high. However, the quality of reporting of the validations was often inadequate to permit a clear interpretation. Not all methods provided a quantitative estimate of validity and most methods considered only the positive predictive value of a set of diagnostic codes in a highly selected group of cases. We make recommendations for methodology and reporting to strengthen further the use of the GPRD in research.
Topics: Algorithms; Clinical Competence; Databases, Factual; Diagnostic Errors; Family Practice; Humans; Reproducibility of Results; Research; Surveys and Questionnaires
PubMed: 20078607
DOI: 10.1111/j.1365-2125.2009.03537.x