Development of a Multimorbidity Illness Perceptions Scale (MULTIPleS)

Background

Illness perceptions are beliefs about the cause, nature and management of illness, which enable patients to make sense of their conditions. These perceptions can predict adjustment and quality of life in patients with single conditions. However, multimorbidity (i.e. patients with multiple long-term conditions) is increasingly prevalent and a key challenge for future health care delivery. The objective of this research was to develop a valid and reliable measure of illness perceptions for multimorbid patients.

Methods

Candidate items were derived from previous qualitative research with multimorbid patients. Questionnaires were posted to 1500 patients with two or more exemplar long-term conditions (depression, diabetes, osteoarthritis, coronary heart disease and chronic obstructive pulmonary disease). Data were analysed using factor analysis and Rasch analysis. Rasch analysis is a modern psychometric technique for deriving unidimensional and intervally-scaled questionnaires.

Results

Questionnaires from 490 eligible patients (32.6% response) were returned. Exploratory factor analysis revealed five potential subscales ‘Emotional representations’, ‘Treatment burden’, ‘Prioritising conditions’, ‘Causal links’ and ‘Activity limitations’. Rasch analysis led to further item reduction and the generation of a summary scale comprising of items from all scales. All scales were unidimensional and free from differential item functioning or local independence of items. All scales were reliable, but for each subscale there were a number of patients who scored at the floor of the scale.

Conclusions

The MULTIPleS measure consists of five individual subscales and a 22-item summary scale that measures the perceived impact of multimorbidity. All scales showed good fit to the Rasch model and preliminary evidence of reliability and validity. A number of patients scored at floor of each subscale, which may reflect variation in the perception of multimorbidity. The MULTIPleS measure will facilitate research into the impact of illness perceptions on adjustment, clinical outcomes, quality of life, and costs in patients with multimorbidity.     

Newcomers and Old-Timers: Educational Philosophies-in-Action of Parent Volunteers in a Community of Learners School

Contrasting educational philosophies-in-action were used by 45 parent volunteers working with children in a school organized as a community of learners. Newcomers were more likely to employ a one-sided philosophy-in-action (with either adult-directed or child-directed organization), whereas parents with several years of experience were more likely to use a collaborative philosophy-in-action, consistent with the philosophy of a community of learners. A pedagogical implication is that adults need opportunities to learn new educational philosophies as they work with children.     

Assessing the Goodness of Fit of Phylogenetic Comparative Methods: A Meta-Analysis and Simulation Study

Background

Phylogenetic comparative methods (PCMs) have been applied widely in analyzing data from related species but their fit to data is rarely assessed.

Question

Can one determine whether any particular comparative method is typically more appropriate than others by examining comparative data sets?

Data

I conducted a meta-analysis of 122 phylogenetic data sets found by searching all papers in JEB, Blackwell Synergy and JSTOR published in 2002–2005 for the purpose of assessing the fit of PCMs. The number of species in these data sets ranged from 9 to 117.

Analysis Method

I used the Akaike information criterion to compare PCMs, and then fit PCMs to bivariate data sets through REML analysis. Correlation estimates between two traits and bootstrapped confidence intervals of correlations from each model were also compared.

Conclusions

For phylogenies of less than one hundred taxa, the Independent Contrast method and the independent, non-phylogenetic models provide the best fit.For bivariate analysis, correlations from different PCMs are qualitatively similar so that actual correlations from real data seem to be robust to the PCM chosen for the analysis. Therefore, researchers might apply the PCM they believe best describes the evolutionary mechanisms underlying their data.     

The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents

Objective

This study was designed to investigate the revised and short version of the smartphone addiction scale and the proof of its validity in adolescents. In addition, it suggested cutting off the values by gender in order to determine smartphone addiction and elaborate the characteristics of smartphone usage in adolescents.

Method

A set of questionnaires were provided to a total of 540 selected participants from April to May of 2013. The participants consisted of 343 boys and 197 girls, and their average age was 14.5 years old. The content validity was performed on a selection of shortened items, while an internal-consistency test was conducted for the verification of its reliability. The concurrent validity was confirmed using SAS, SAPS and KS-scale. Receiver operating characteristics analysis was conducted to suggest cut-off.

Results

The 10 final questions were selected using content validity. The internal consistency and concurrent validity of SAS were verified with a Cronbach''s alpha of 0.911. The SAS-SV was significantly correlated with the SAS, SAPS and KS-scale. The SAS-SV scores of gender (p<.001) and self-evaluation of smartphone addiction (p<.001) showed significant difference. The ROC analysis results showed an area under a curve (AUC) value of 0.963(0.888–1.000), a cut-off value of 31, sensitivity value of 0.867 and specificity value of 0.893 in boys while an AUC value of 0.947(0.887–1.000), a cut-off value of 33, sensitivity value of 0.875, and a specificity value of 0.886 in girls.

Conclusions

The SAS-SV showed good reliability and validity for the assessment of smartphone addiction. The smartphone addiction scale short version, which was developed and validated in this study, could be used efficiently for the evaluation of smartphone addiction in community and research areas.     

Child Maltreatment Experience among Primary School Children: A Large Scale Survey in Selangor State,Malaysia

Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10–12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.     

Management of Inpatient Hyperglycemia: Assessing Perceptions and Barriers to Care Among Resident Physicians

Objective:To develop insight into resident physician attitudes about inpatient hyperglycemia and determine perceived barriers to optimal management.Methods:As part of a planned educational program, a questionnaire was designed and administered to determine the opinions of residents about the importance o inpatient glucose control, their perceptions about what glucose ranges were desirable, and the problems they encountered when trying to manage hyperglycemia in hospitalized patients.ResultsOf 70 resident physicians from various services, 52 completed the survey (mean age, 31 years; 48% men; 37% in first year of residency training). Most respondents indicated that glucose control was “very important” in critically ill and perioperative patients but only “somewhat important” in non-critically ill patients. Most residents indicated that they would target a therapeutic glucose range within the recommended levels in published guidelines. Most residents also said they felt “somewhat comfortable” managing hyperglycemia and hypoglycemia and using subcutaneous insulin therapy. whereas most residents (48%) were “not at all comfortable” with use of intravenous administration of insulin. In general, respondents were not very familiar with existing institutional policies and preprinted order sets relating to glucose management. The most commonly reported barrier to management of inpatient hyperglycemia was lack of knowledge about appropriate insulin regimens and how to use them. Anxiety about hypoglycemia was only the third most frequent concern.ConclusionMost residents acknowledged the importance of good glucose control in hospitalized patients and chose target glucose ranges consistent with existing guidelines. Lack of knowledge about insulin treatment options was the most commonly cited barrier to ideal management. Educational programs should emphasize inpatient treatment strategies for glycemic control. (Endocr Pract. 2007;13:117-125)     

Development and Validation of the Body Size Scale for Assessing Body Weight Perception in African Populations

Background

The social valorisation of overweight in African populations could promote high-risk eating behaviours and therefore become a risk factor of obesity. However, existing scales to assess body image are usually not accurate enough to allow comparative studies of body weight perception in different African populations. This study aimed to develop and validate the Body Size Scale (BSS) to estimate African body weight perception.

Methods

Anthropometric measures of 80 Cameroonians and 81 Senegalese were used to evaluate three criteria of adiposity: body mass index (BMI), overall percentage of fat, and endomorphy (fat component of the somatotype). To develop the BSS, the participants were photographed in full face and profile positions. Models were selected for their representativeness of the wide variability in adiposity with a progressive increase along the scale. Then, for the validation protocol, participants self-administered the BSS to assess self-perceived current body size (CBS), desired body size (DBS) and provide a “body self-satisfaction index.” This protocol included construct validity, test-retest reliability and convergent validity and was carried out with three independent samples of respectively 201, 103 and 1115 Cameroonians.

Results

The BSS comprises two sex-specific scales of photos of 9 models each, and ordered by increasing adiposity. Most participants were able to correctly order the BSS by increasing adiposity, using three different words to define body size. Test-retest reliability was consistent in estimating CBS, DBS and the “body self-satisfaction index.” The CBS was highly correlated to the objective BMI, and two different indexes assessed with the BSS were consistent with declarations obtained in interviews.

Conclusion

The BSS is the first scale with photos of real African models taken in both full face and profile and representing a wide and representative variability in adiposity. The validation protocol proved its reliability for estimating body weight perception in Africans.     

Changing Perceptions of Risk: The Development of Agro-Ecosystems in Southeast Asia

New long-term environmental sequences for Southeast Asia provide a basis for reevaluating the development of agroecosystems. Previous models depict agricultural development as a singular, relatively rapid response to various stimuli such as climate change and population growth. In contrast, the Southeast Asian data indicate that the development of tropical agro-ecosystems are the result of stresses separated in time and not part of a unitary developmental process. Two phases are evident: At the end of the Pleistocene, environmental data indicate a significant climatic change that would have affected the distribution of food resources. In some areas, this encouraged food production as previous food resources decreased or disappeared. In the second phase, during the mid- Holocene, increased cultural and social risks led to shifts in strategies that created agro-ecosystems—a more fundamental transformation of landscape ecology. This distinct two-phase pattern suggests groups were responding to very different challenges in each period These findings underscore the need to reexamine agricultural models that conflate separate and distinct processes of cultural change. [Keywords: Southeast Asia, tropical land use, phytoliths, agriculture, Thailand]     

Assessing Depression Related Severity and Functional Impairment: The Overall Depression Severity and Impairment Scale (ODSIS)

Background

The Overall Depression Severity and Impairment Scale (ODSIS) is a brief, five-item measure for assessing the frequency and intensity of depressive symptoms, as well as functional impairments in pleasurable activities, work or school, and interpersonal relationships due to depression. Although this scale is expected to be useful in various psychiatric and mental health settings, the reliability, validity, and interpretability have not yet been fully examined. This study was designed to examine the reliability, factorial, convergent, and discriminant validity of a Japanese version of the ODSIS, as well as its ability to distinguish between individuals with and without a major depressive disorder diagnosis.

Methods

From a pool of registrants at an internet survey company, 2830 non-clinical and clinical participants were selected randomly (619 with major depressive disorder, 619 with panic disorder, 576 with social anxiety disorder, 645 with obsessive–compulsive disorder, and 371 non-clinical panelists). Participants were asked to respond to the ODSIS and conventional measures of depression, functional impairment, anxiety, neuroticism, satisfaction with life, and emotion regulation.

Results

Exploratory and confirmatory factor analysis of three split subsamples indicated the unidimensional factor structure of ODSIS. Multi-group confirmatory factor analysis showed invariance of factor loadings between non-clinical and clinical subsamples. The ODSIS also showed excellent internal consistency and test–retest intraclass correlation coefficients. Convergence and discriminance of the ODSIS with various measures were in line with our expectations. Receiver operating characteristic curve analyses showed that the ODSIS was able to detect a major depressive syndrome accurately.

Conclusions

This study supports the reliability and validity of ODSIS in a non-western population, which can be interpreted as demonstrating cross-cultural validity.     

The Affective Slider: A Digital Self-Assessment Scale for the Measurement of Human Emotions

Self-assessment methods are broadly employed in emotion research for the collection of subjective affective ratings. The Self-Assessment Manikin (SAM), a pictorial scale developed in the eighties for the measurement of pleasure, arousal, and dominance, is still among the most popular self-reporting tools, despite having been conceived upon design principles which are today obsolete. By leveraging on state-of-the-art user interfaces and metacommunicative pictorial representations, we developed the Affective Slider (AS), a digital self-reporting tool composed of two slider controls for the quick assessment of pleasure and arousal. To empirically validate the AS, we conducted a systematic comparison between AS and SAM in a task involving the emotional assessment of a series of images taken from the International Affective Picture System (IAPS), a database composed of pictures representing a wide range of semantic categories often used as a benchmark in psychological studies. Our results show that the AS is equivalent to SAM in the self-assessment of pleasure and arousal, with two added advantages: the AS does not require written instructions and it can be easily reproduced in latest-generation digital devices, including smartphones and tablets. Moreover, we compared new and normative IAPS ratings and found a general drop in reported arousal of pictorial stimuli. Not only do our results demonstrate that legacy scales for the self-report of affect can be replaced with new measurement tools developed in accordance to modern design principles, but also that standardized sets of stimuli which are widely adopted in research on human emotion are not as effective as they were in the past due to a general desensitization towards highly arousing content.     

The Food Amount Rating Scale: Development,Reliability, and Validity

Objective: Implied in measures of binge eating is the assumption that individuals agree on what comprises a large amount of food. However, whether individuals estimate food amounts similarly or whether estimation of food amounts varies as a function of personal characteristics is unknown. The Food Amount Rating Scale (FARS) is a standardized set of stimuli for assessing individuals’ judgment of food amounts. Research Methods and Procedures: Two versions of the FARS were developed, and their psychometric properties were assessed. These versions are the same in all respects except that the rater is instructed to rate various food amounts for the average woman on Form W and for the average man on Form M. Results: Content validity was confirmed by 14 researchers and research assistants in the field of eating disorders. The FARS is a 24-item inventory with adequate test–retest reliability (Form W = 0.85; Form M = 0.87) and split–half reliability (Form W = 0.90; Form M = 0.89). Convergent validity is suggested by the finding that ratings for the average woman (Form W) were significantly higher than ratings for the average man (Form M). Discussion: The FARS is a psychometrically sound tool for use in basic research focused on identifying whether the subjective judgment of food amounts varies as a function of personal characteristics and in clinical research where it may be important to know how individuals judge food amounts.     

Development and Validation of a Tuberculosis Medication Adherence Scale

Background

Medication adherence is critical in Tuberculosis (TB) treatment success, but existing tools are inadequate in identifying non-adherents, reasons for non-adherence or interventions to improve adherence. This study intended to fill the gap by developing and validating a TB medication adherence scale (TBMAS).

Methods

An initial 41-item TBMAS was designed through review of literature, consultation from an 8-member clinical expert panel and a 15-patient focus group, and pilot-testing in 25 TB patients. The questionnaire was validated in 438 patients who visited 23 community health centers for TB treatment in Wuhan from September 1, 2010, to August 31, 2011, using pharmacy refill records in a 15-week period as external criteria for medication adherence. After removing redundant and cross-loading items, the internal consistency, reliability and validity of TBMAS in identifying non-adherents were examined.

Results

The final TBMAS included 30 items scored on a 5-point Likert scale, and these items were loaded in nine distinct factors that explained 65% of cumulative variance among respondents. Cronbach''s alpha, test-retest reliability and split-half reliability were 0.87, 0.83, and 0.85, respectively. Convergent validity was supported by statistically significant associations between TBMAS scores and adherence measured by pharmacy refill records. Receiver Operating Characteristics curve analysis suggested a cut-off point at 113, with which TBMAS showed a positive predictive value of 65.5% and sensitivity of 82.9% in identifying non-adherents.

Conclusion

TBMAS demonstrated satisfactory internal consistency, reliability and validity in identifying TB patients with poor adherence and potential causes for non-adherence.     

Victims and Aggressors at School: Teacher,Self, and Peer Perceptions of Psychosocial Functioning

Scholars theorize that engaging young people in organizational governance promotes positive youth development and organizational effectiveness. To explore this prediction, the study discussed here, based on interview data from 16 youth and 24 adult organizational leaders representing 8 organizations, mapped the developmental processes that occur when youth and adults share governance responsibilities. It was found that engaging youth in decision making secured the commitment of young people to their organizational communities, and additionally, contributed positively to youth development. Further, the adult leaders reported that the experience of working with youth had a positive effect on their own development and contributed to the overall efficacy of their organizations. These data indicate that organizational governance may offer a viable context through which youth can be active producers of their own development and of the communities in which they interact. Implications for future research and practice are discussed in light of these findings.     

Sense of Purpose Scale: Development and initial validation

This study focused on the development of the Sense of Purpose Scale and demonstrated three empirically interpretable subscales: awareness of purpose, awakening to purpose, and altruistic purpose. The results provided initial evidence for all three subscales reliability and validity with a sample of 300 undergraduate students. Future research should focus on the further validation and revision of items to increase all three subscales internal consistency.     

某军校新生人格特征分析及建议

目的:调查某军校大一新生的人格特征及心理健康状况,为开展军校学员心理健康教育提供科学依据。方法:采用卡特尔16种个性因素测验(16PF)对1224名大一学员进行测试。结果:除乐群性和世故性外,在剩余14个因素上,新学员的结果与全国成年人常模均存在显著差异;其中,来自城市的学员与农村学员在乐群性、兴奋性、敢为性、敏感性、怀疑性、幻想性和世故性因子有显著差异;独生子女与非独生子女在兴奋性、怀疑性、实验性和独立性上,表现出显著差异。结论:该校大一学员整体心理健康状况良好,但在恃强性、兴奋性、敢为性、幻想性因子得分偏高,应进行系统教育和调控;同时,也要注重城市学员与农村学员、独生子女与非独生子女之间的心理差距,因材施教,共同提高。