医生职业倦怠量表的编制及信效度检验

目的:编制医生职业倦怠量表.方法:通过查阅文献、访谈及专家讨论,建立量表结构,并确定初始量表项目48条.在西安的两所三级甲等医院施测,2次分别选取176和436名医生作为样本.采用项目分析、探索性因素分析、信度分析、验证性因素分析等统计方法对数据进行统计分析.结果:医生职业倦怠量表由六个因素构成:疲劳感、工作能力下降、投入性下降、成就感降低、工作控制感下降以及工作前景.共有30个项目,量表总分与各因素之间的相关系数0.541～0.856(P＜0.001).六个因素的α系数在0.886～0.896之间,总量表的α系数为0.894.验证性因素分析拟合度较高(RESEA=0.062,GFI=0.859,CFI=0.842,IFI=0.851).医生职业倦怠量表总分及各因子分与工作倦怠问卷的总分及各因子分之间具有显著的相关性(P＜0.05).结论:编制的医生职业倦怠量表信度和效度符合心理测量学要求,可以作为医生职业倦怠测量的工具.     

The assessment of post-vasectomy pain in mice using behaviour and the Mouse Grimace Scale

Background

Current behaviour-based pain assessments for laboratory rodents have significant limitations. Assessment of facial expression changes, as a novel means of pain scoring, may overcome some of these limitations. The Mouse Grimace Scale appears to offer a means of assessing post-operative pain in mice that is as effective as manual behavioural-based scoring, without the limitations of such schemes. Effective assessment of post-operative pain is not only critical for animal welfare, but also the validity of science using animal models.

Methodology/Principal Findings

This study compared changes in behaviour assessed using both an automated system (“HomeCageScan”) and using manual analysis with changes in facial expressions assessed using the Mouse Grimace Scale (MGS). Mice (n = 6/group) were assessed before and after surgery (scrotal approach vasectomy) and either received saline, meloxicam or bupivacaine. Both the MGS and manual scoring of pain behaviours identified clear differences between the pre and post surgery periods and between those animals receiving analgesia (20 mg/kg meloxicam or 5 mg/kg bupivacaine) or saline post-operatively. Both of these assessments were highly correlated with those showing high MGS scores also exhibiting high frequencies of pain behaviours. Automated behavioural analysis in contrast was only able to detect differences between the pre and post surgery periods.

Conclusions

In conclusion, both the Mouse Grimace Scale and manual scoring of pain behaviours are assessing the presence of post-surgical pain, whereas automated behavioural analysis could be detecting surgical stress and/or post-surgical pain. This study suggests that the Mouse Grimace Scale could prove to be a quick and easy means of assessing post-surgical pain, and the efficacy of analgesic treatment in mice that overcomes some of the limitations of behaviour-based assessment schemes.     

Development and Psychometric Evaluation of the Cat Care and Needs Scale (CCANS)

The objective of this study was to develop a brief scale, primarily intended for research applications, that measures how well people report meeting the welfare needs of their pet cats. The practice of keeping cats as a companion animal has increased, and despite their popularity, many cats suffer from poor welfare and behavioral problems. The failure to meet their welfare needs and provide for natural behaviors impacts their quality of life and may affect cats’ retention in adoptive homes. We present three studies in which we developed, piloted, and psychometrically evaluated the Cat Care and Needs Scale (CCANS) by surveying cat guardians, examining their selfreported care-taking habits and interactions in regards to a pet cat. The final study (n = 1,591) resulted in a 15-item scale which shows high reliability, with application of item response theory indicating that individual items were all suitable for inclusion. Diverse evidence, including a factor analysis, parallel analysis, and confirmatory factor analysis, supports that the scale is unidimensional. The CCANS is scalable and allows for correlational comparisons with other scales which measure any variable of interest in research exploring human–companion animal relationships or cat welfare. We propose that the CCANS scale is a step forward in measuring how well pet owners understand and meet their cats’ behavioral, welfare, and basic care needs.     

A Psychometric Evaluation and Validation of the Preferences Scale

The Preferences Scale (PS) is a new measure of morningness and therefore requires intensive investigation to establish its measurement properties and validity. A confirmatory factor analysis (CFA) of Smith and colleagues (2002) posited model structure was not optimal in both a student (n=731) and working sample (n=218). However, significant differences (p<0.01) were found for times to sleep and wake between morning and evening types. Principal components and reliability analyses were used to develop a 6‐item model comprising 2 factors using a student sample (n=368). Cronbach's α for the PS was 0.73 and the factors explained 61% of the variance. The revised model was replicated via CFA in a separate student sample (n=363). A subsequent CFA confirmed the model structure in the working sample. Cronbach's α was 0.74 and the factors explained 64% of the variance. Significant differences (p<0.01) in self‐reported alertness ratings between morning and evening types were obtained by time‐of‐day. These results provide preliminary support for the PS. The predictive efficacy of the PS requires further validation against a number of health and work‐related variables.     

Psychometric properties of the Zung Self-Rating Depression Scale

Some psychometric parameters of the instrument were estimated using a sample of depressed patients and a sample of normal subjects from the Czech population. The findings considerably support the hypothesis that the SDS items belong to the same psychometric family. Most items and the scale as a whole show a remarkable ability to discriminate between normal subjects and those suffering from depressive disorder. The result also rather convincingly indicate the SDS capacity to monitor changes of depressive disorder symptoms during treatment to be rather independent of relatively stable personality traits as measured by the EPQ. It might be concluded that the SDS psychometric parameters qualify the instrument for measurement of milder forms of depressive disorder in the Czech population.     

Development of an Adverse Drug Reaction Risk Assessment Score among Hospitalized Patients with Chronic Kidney Disease

Background

Adverse drug reactions (ADRs) represent a major burden on the healthcare system. Chronic kidney disease (CKD) patients are particularly vulnerable to ADRs because they are usually on multiple drug regimens, have multiple comorbidities, and because of alteration in their pharmacokinetics and pharmacodynamic parameters. Therefore, one step towards reducing this burden is to identify patients who are at increased risk of an ADR.

Objective

To develop a method of identifying CKD patients who are at increased risk for experiencing ADRs during hospitalisation.

Materials and Methods

Factors associated with ADRs were identified by using demographic, clinical and laboratory variables of patients with CKD stages 3 to 5 (estimated glomerular filtration rate, 10–59 ml/min/1.73 m²) who were admitted between January 1, 2012, and December 31, 2012, to the renal unit of Dubai Hospital. An ADR risk score was developed by constructing a series of logistic regression models. The overall model performance for sequential models was evaluated using Akaike Information Criterion for goodness of fit. Odd ratios of the variables retained in the best model were used to compute the risk scores.

Results

Of 512 patients (mean [SD] age, 60 [16] years), 62 (12.1%) experienced an ADR during their hospitalisation. An ADR risk score included age 65 years or more, female sex, conservatively managed end-stage renal disease, vascular disease, serum level of C-reactive protein more than 10 mg/L, serum level of albumin less than 3.5 g/dL, and the use of 8 medications or more during hospitalization. The C statistic, which assesses the ability of the risk score to predict ADRs, was 0.838; 95% CI, 0.784–0.892).

Conclusion

A score using routinely available patient data can be used to identify CKD patients who are at increased risk of ADRs.     

Development of the Final Version of the Classification and Assessment of Occupational Dysfunction Scale

Occupational therapy is involved in disability prevention and health enhancement through the prevention of occupational dysfunction. Although many occupational dysfunction scales exist, no standard method is available for the assessment and classification of occupational dysfunction, which may include occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization. The purpose of this study was to develop the final version of Classification and Assessment of Occupational Dysfunction (CAOD). Our study demonstrated the validity and reliability of CAOD in a group of undergraduate students. The CAOD scale includes 16 items and addresses the following 4 domains: occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization.     

医务人员工作满意度测评量表的研制及验证研究

目的 针对当前学术界及实践工作者聚焦关注的医务人员工作满意度测评,以及文献综述发现其测评量表忽视和缺失考察了患方及社会舆论因素对其满意度的影响以及医患满意协同的作用,修正研制完善其测评量表并进行信效度评价。方法 运用文献资料及专题小组讨论法编制医务人员工作满意度量表,并对浙江省8家综合医院573名医务人员进行问卷调查,采用内部一致性检验、Spearman相关分析和因子分析等方法对量表信度、效度进行评价。结果 量表的内部一致性系数为0.917,分半信度为0.953,各条目得分与总体得分相关系数在0.403～0.759之间(P＜0.01);因子分析发现量表6个维度结构较为合理,可累积解释总体方差变异的72.89%。结论 量表在条目设计上弥补了患者对医务人员的尊重、认可、信任及社会舆论环境等因素对其满意度影响的考察,总体及各维度信效度较好,可作为医务人员工作满意度测评及治理的参考工具。     

Psychometric properties of the Russian version of the Composite Scale of Morningness

Morningness–eveningness preference is commonly measured by questionnaires, such as the Composite Scale of Morningness (CSM). Purpose of our study was to assess the Russian translation of the CSM and provide psychometric properties of this scale. Participants (N = 406) were students from high schools and university in Petrozavodsk. Mean age was 20.47 ± 3.66 with a range of 12–38 years. Mean CSM scores were 31.43 ± 6.32, with a range from 14 to 50. Internal reliability, as measured by Cronbach’s α, was 0.823. There was no negative correlation among the items. The reliability of 0.82 is good and fits into previous work done with the CSM in many different countries. The factor structure appears as a two-factor structure based on parallel analysis and a three-factor structure based on the eigenvalue greater than one criterion. We suggest retaining the two-factor structure, one factor could be labelled as morning affect and the other one as self-assessment/activity planning. Construct validity was checked with the MCTQ and showed that the correlations between midpoint of sleep and CSM are comparable to other studies.     

Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context

Background

HIV-related stigma has negative consequences for infected people''s lives and is a barrier to HIV prevention. Therefore valid and reliable instruments to measure stigma are needed to enable mapping of HIV stigma. This study aimed to evaluate the psychometric properties of the HIV stigma scale in a Swedish context with regard to construct validity, data quality, and reliability.

Methods

The HIV stigma scale, developed by Berger, Ferrans, and Lashley (2001), was distributed to a cross-sectional sample of people living with HIV in Sweden (n = 194). The psychometric evaluation included exploratory factor analysis together with an analysis of the distribution of scores, convergent validity by correlations between the HIV stigma scale and measures of emotional well-being, and an analysis of missing items and floor and ceiling effects. Reliability was assessed using Cronbach''s α.

Results

The exploratory factor analysis suggested a four-factor solution, similar to the original scale, with the dimensions personalised stigma, disclosure concerns, negative self-image, and concerns with public attitudes. One item had unacceptably low loadings and was excluded. Correlations between stigma dimensions and emotional well-being were all in the expected direction and ranged between −0.494 and −0.210. The instrument generated data of acceptable quality except for participants who had not disclosed their HIV status to anybody. In line with the original scale, all subscales demonstrated acceptable internal consistency with Cronbach''s α 0.87–0.96.

Conclusion

A 39-item version of the HIV stigma scale used in a Swedish context showed satisfactory construct validity and reliability. Response alternatives are suggested to be slightly revised for items assuming the disclosure of diagnosis to another person. We recommend that people that have not disclosed should skip all questions belonging to the dimension personalised stigma. Our analysis confirmed construct validity of the instrument even without this dimension.     

Weight Bias Internalization Scale: Psychometric Properties and Population Norms

Objective

Internalizing the pervasive weight bias commonly directed towards individuals with overweight and obesity, co-occurs with increased psychopathology and impaired quality of life. This study sought to establish population norms and psychometric properties of the most widely used self-report questionnaire, the Weight Bias Internalization Scale (WBIS), in a representative community sample.

Design and Methods

In a survey of the German population, N = 1158 individuals with overweight and obesity were assessed with the WBIS and self-report measures for convergent validation.

Results

Item analysis revealed favorable item-total correlation of all but one WBIS item. With this item removed, item homogeneity and internal consistency were excellent. The one-factor structure of the WBIS was confirmed using confirmatory factor analysis. Convergent validity was shown through significant associations with measures of depressive and somatoform symptoms. The WBIS contributed to the explanation of variance in depressive and somatoform symptoms over and above body mass index. Higher WBIS scores were found in women than in men, in individuals with obesity than in individuals with overweight, and in those with lower education or income than those with higher education or income. Sex-specific norms were provided.

Conclusions

The results showed good psychometric properties of the WBIS after removal of one item. Future research is warranted on further indicators of reliability and validity, for example, retest reliability, sensitivity to change, and prognostic validity.     

Implementation and Assessment of an Intervention to Debias Adolescents against Causal Illusions

Researchers have warned that causal illusions are at the root of many superstitious beliefs and fuel many people’s faith in pseudoscience, thus generating significant suffering in modern society. Therefore, it is critical that we understand the mechanisms by which these illusions develop and persist. A vast amount of research in psychology has investigated these mechanisms, but little work has been done on the extent to which it is possible to debias individuals against causal illusions. We present an intervention in which a sample of adolescents was introduced to the concept of experimental control, focusing on the need to consider the base rate of the outcome variable in order to determine if a causal relationship exists. The effectiveness of the intervention was measured using a standard contingency learning task that involved fake medicines that typically produce causal illusions. Half of the participants performed the contingency learning task before participating in the educational intervention (the control group), and the other half performed the task after they had completed the intervention (the experimental group). The participants in the experimental group made more realistic causal judgments than did those in the control group, which served as a baseline. To the best of our knowledge, this is the first evidence-based educational intervention that could be easily implemented to reduce causal illusions and the many problems associated with them, such as superstitions and belief in pseudoscience.     

Psychometric properties of the Chinese version of the Perceived Stress Scale in policewomen

Background

The 10-item Perceived Stress Scale (PSS-10) is one of most widely used instruments to measure a global level of perceived stress in a range of clinical and research settings. This study was conducted to examine the psychometric properties of the Simplified Chinese version of the PSS-10 in policewomen.

Methodology

A total of 240 policewomen were recruited in this study. The Simplified Chinese versions of the PSS-10, the Beck Depression Inventory Revised (BDI-II), and the Beck Anxiety Inventory (BAI) were administered to all participants, and 36 of the participants were re-tested two weeks after the initial testing.

Principal Findings

The overall Cronbach''s alpha was 0.86, and the test–retest reliability coefficient was 0.68. Exploratory Factor Analysis (EFA) yielded 2 factors with eigenvalues of 4.76 and 1.48, accounting for 62.41% of variance. Factor 1 consisted of 6 items representing “negative feelings”; whereas Factor 2 consisted of 4 items representing “positive feelings”. The item loadings ranged from 0.72 to 0.83. The Confirmatory factor analysis (CFA) indicated a very good fit of this two-factor model to this sample. The PSS-10 significantly correlated with both BDI-II and BAI, indicating an acceptable concurrent validity.

Conclusions

The Simplified Chinese version of the PSS-10 demonstrated adequate psychometric properties for evaluating stress levels. The results support its use among the Chinese population.     

Psychometric Evaluation of the Lexington Attachment to Pets Scale (Laps)

Abstract

This paper reports on the development and psychometric evaluation of a scale for assessing emotional attachment of individuals to their pets. Previous attachment scales have suffered variously from low internal consistency and reliance on small or nonrepresentative samples for their development. Telephone interviews of a random, representative sample of 412 pet owners in Fayette County, Kentucky, were completed in September 1990; a 69.5 percent response rate was achieved. From a preliminary set of 42 questions, a final 23-question instrument, the Lexington Attachment to Pets Scale (LAPS), was developed, having excellent psychometric properties. The scale is suitable for use with dog and cat owners. Data on internal consistency, factor structure, and item response theory (IRT) modeling are presented, along with correlations between the LAPS and several domains of variables known to relate to pet attachment.     

实验性2型糖尿病心肌病大鼠模型的建立与评价

目的建立和评价2型糖尿病心肌病（DC）大鼠模型,探究高糖脂饮食在模型建立中的作用。方法将雄性Wistar大鼠随机分成正常对照组、高糖脂饮食组和高糖脂负荷小剂量STZ组。高糖高脂膳食诱导11周负荷小剂量链脲佐菌素（STZ）（30 mg/kg）腹腔注射建立DC模型,并观察糖代谢、脂代谢和心功能的变化。结果①大鼠经高糖高脂饲料诱导4周后,与正常对照组相比,胆固醇（TCH）和甘油三酯（TG）均显著增高（P〈0.05）,血糖值没有明显变化（P〉0.05）。②大鼠注射30 mg/kg STZ后72 h,血糖水平开始升高,继续以高糖高脂饲料喂养6周后,与正常对照组比较,高糖脂饮食组和高糖脂负荷小剂量STZ组大鼠TG、TCH维持高水平,差异有显著性（P〈0.05）;高糖脂负荷小剂量STZ组大鼠血糖值持续高水平,与正常对照组差异有显著性（P〈0.001）。③心功能测量结果显示,高糖脂饮食组大鼠出现温和的心脏功能异常（左心室收缩压降低,左心室舒张末压升高）;高糖脂负荷小剂量STZ组大鼠左心室收缩和舒张功能均出现异常（LVSP、每搏输出量、心排量降低,LVEDP、左心室最大舒张速率升高）,但以舒张功能异常为主。结论大鼠高糖脂饮食诱导负荷小剂量STZ可建立类似临床症状的2型DC模型,高糖脂饮食在糖脂代谢紊乱和心脏功能损伤过程中有重要作用,结合糖、脂代谢指标和心脏功能指标可以有效简便评价糖尿病心肌病模型。     

Angiographic Lesion Complexity Score and In-Hospital Outcomes after Percutaneous Coronary Intervention

Objective

We devised a percutaneous coronary intervention (PCI) scoring system based on angiographic lesion complexity and assessed its association with in-hospital complications.

Background

Although PCI is finding increasing application in patients with coronary artery disease, lesion complexity can lead to in-hospital complications.

Methods

Data from 3692 PCI patients were scored based on lesion complexity, defined by bifurcation, chronic total occlusion, type C, and left main lesion, along with acute thrombus in the presence of ST-segment elevation myocardial infarction (1 point assigned for each variable).

Results

The patients’ mean age was 67.5 +/- 10.8 years; 79.8% were male. About half of the patients (50.3%) presented with an acute coronary syndrome, and 2218 (60.1%) underwent PCI for at least one complex lesion. The patients in the higher-risk score groups were older (p < 0.001) and had present or previous heart failure (p = 0.02 and p = 0.01, respectively). Higher-risk score groups had significantly higher in-hospital event rates for death, heart failure, and cardiogenic shock (from 0 to 4 risk score; 1.7%, 4.5%, 6.3%, 7.1%, 40%, p < 0.001); bleeding with a hemoglobin decrease of >3.0 g/dL (3.1%, 11.0%, 13.1%, 10.3%, 28.6%, p < 0.001); and postoperative myocardial infarction (1.5%, 3.1%, 3.8%, 3.8%, 10%, p = 0.004), respectively. The association with adverse outcomes persisted after adjustment for known clinical predictors (odds ratio 1.72, p < 0.001).

Conclusion

The complexity score was cumulatively associated with in-hospital mortality and complication rate and could be used for event prediction in PCI patients.     

Psychometric Evaluation of the Altered States of Consciousness Rating Scale (OAV)

Background

The OAV questionnaire has been developed to integrate research on altered states of consciousness (ASC). It measures three primary and one secondary dimensions of ASC that are hypothesized to be invariant across ASC induction methods. The OAV rating scale has been in use for more than 20 years and applied internationally in a broad range of research fields, yet its factorial structure has never been tested by structural equation modeling techniques and its psychometric properties have never been examined in large samples of experimentally induced ASC.

Methodology/Principal Findings

The present study conducted a psychometric evaluation of the OAV in a sample of psilocybin (n = 327), ketamine (n = 162), and MDMA (n = 102) induced ASC that was obtained by pooling data from 43 experimental studies. The factorial structure was examined by confirmatory factor analysis, exploratory structural equation modeling, hierarchical item clustering (ICLUST), and multiple indicators multiple causes (MIMIC) modeling. The originally proposed model did not fit the data well even if zero-constraints on non-target factor loadings and residual correlations were relaxed. Furthermore, ICLUST suggested that the “oceanic boundlessness” and “visionary restructuralization” factors could be combined on a high level of the construct hierarchy. However, because these factors were multidimensional, we extracted and examined 11 new lower order factors. MIMIC modeling indicated that these factors were highly measurement invariant across drugs, settings, questionnaire versions, and sexes. The new factors were also demonstrated to have improved homogeneities, satisfactory reliabilities, discriminant and convergent validities, and to differentiate well among the three drug groups.

Conclusions/Significance

The original scales of the OAV were shown to be multidimensional constructs. Eleven new lower order scales were constructed and demonstrated to have desirable psychometric properties. The new lower order scales are most likely better suited to assess drug induced ASC.     

Preclinical Assessment of the Analgesic Pharmacology of NKTR-181 in Rodents

Cellular and Molecular Neurobiology - Pharmacological evaluation of the mu-opioid receptor (MOR) agonist properties of NKTR-181 in rodent models. Graded noxious stimulus intensities were used in...     

The Psychometric Evaluation of the Connor-Davidson Resilience Scale Using a Chinese Military Sample

This study examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) with a Chinese military population with the aim of finding a suitable instrument to quantify resilience in Chinese military service members. The confirmatory factor analysis results did not support the factorial structure of the original or the Chinese community version of the CD-RISC, but the exploratory factor analysis results revealed a three-factor model (composed of Competency, Toughness, and Adaptability) that seemed to fit. Moreover, the repeat confirmatory factory analysis replicated the three-factor model. Additionally, the CD-RISC with a Chinese military sample exhibited appropriate psychometric properties, including internal consistency, test-retest reliability, and structural and concurrent validity. The revised CD-RISC with a Chinese military sample provides insight into the resilience measurement framework and could be a reliable and valid measurement for evaluating resilience in a Chinese military population.     

Psychometric Properties of the Participation Scale among Former Buruli Ulcer Patients in Ghana and Benin

Background

Buruli ulcer is a stigmatising disease treated with antibiotics and wound care, and sometimes surgical intervention is necessary. Permanent limitations in daily activities are a common long term consequence. It is unknown to what extent patients perceive problems in participation in social activities. The psychometric properties of the Participation Scale used in other disabling diseases, such as leprosy, was assessed for use in former Buruli ulcer patients.

Methods

Former Buruli ulcer patients in Ghana and Benin, their relatives, and healthy community controls were interviewed using the Participation Scale, Buruli Ulcer Functional Limitation Score, and the Explanatory Model Interview Catalogue to measure stigma. The Participation Scale was tested for the following psychometric properties: discrimination, floor and ceiling effects, internal consistency, inter-item correlation, item-total correlation and construct validity.

Results

In total 386 participants (143 former Buruli ulcer patients with their relatives (137) and 106 community controls) were included in the study. The Participation Scale displayed good discrimination between former Buruli ulcer patients and healthy community controls. No floor and ceiling effects were found. Internal consistency (Cronbach''s alpha) was 0.88. In Ghana, mean inter-item correlation of 0.29 and item-total correlations ranging from 0.10 to 0.69 were found while in Benin, a mean inter-item correlation of 0.28 was reported with item-total correlations ranging from −0.08 to 0.79. With respect to construct validity, 4 out of 6 hypotheses were not rejected, though correlations between various constructs differed between countries.

Conclusion

The results indicate the Participation Scale has acceptable psychometric properties and can be used for Buruli ulcer patients in Ghana and Benin. Future studies can use this Participation Scale to evaluate the long term restrictions in participation in daily social activities of former BU patients.