Using the Rasch measurement model in psychometric analysis of the Family Effectiveness Measure

The ethos brief index-validation of a brief questionnaire to evaluate wellness based on a holistic perspective in patients with restless legs syndrome

PURPOSE

The aim of this study was to validate the Ethos Brief Index (EBI) in patients with Restless Legs Syndrome (RLS).

METHODS

A cross-sectional design, including 788 subjects with RLS (65% women, 70.8 years, SD 11.3) from the Swedish RLS Association, was used. A postal survey was sent out to collect data regarding socio demographics, comorbidities, and RLS-related treatment data. Questionnaires included were EBI, the Restless Legs Syndrome-6 Scale (RLS-6), Restless Legs Syndrome-Quality of Life questionnaire (RLSQoL), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis (CFA) models. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age and gender groups, as well as insomnia, daytime sleepiness, RLS-related QoL and RLS severity were assessed.

RESULTS

The results supported the unidimensionality of the EBI in the CFA (i.e., explaining 61.5% of the variance) and the Rasch model. The reliability of the EBI was confirmed using composite reliability and Cronbach's alpha. No DIF was identified for gender, age, insomnia, daytime sleepiness, RLS severity or RLS-related QoL.

CONCLUSION

The EBI showed good validity and reliability and operated equivalently for male and female patients with RLS. Accordingly, healthcare professionals can use the EBI as a psychometrically sound tool to explore and identify patient-centered problems related to the whole life situation.

What Affects the Quality of Score Transformations? Potential Issues in True-Score Equating Using the Partial Credit Model

This simulation study investigated to what extent departures from construct similarity as well as differences in the difficulty and targeting of scales impact the score transformation when scales are equated by means of concurrent calibration using the partial credit model with a common person design. Practical implications of the simulation results are discussed with a focus on scale equating in health-related research settings. The study simulated data for two scales, varying the number of items and the sample sizes. The factor correlation between scales was used to operationalize construct similarity. Targeting of the scales was operationalized through increasing departure from equal difficulty and by varying the dispersion of the item and person parameters in each scale. The results show that low similarity between scales goes along with lower transformation precision. In cases with equal levels of similarity, precision improves in settings where the range of the item parameters is encompassing the person parameters range. With decreasing similarity, score transformation precision benefits more from good targeting. Difficulty shifts up to two logits somewhat increased the estimation bias but without affecting the transformation precision. The observed robustness against difficulty shifts supports the advantage of applying a true-score equating methods over identity equating, which was used as a naive baseline method for comparison. Finally, larger sample size did not improve the transformation precision in this study, longer scales improved only marginally the quality of the equating. The insights from the simulation study are used in a real-data example.

Perceived difficulties in maintaining menstrual hygiene practices among indigenous adolescents during seasonal water scarcity periods in Bandarban hill district of Bangladesh: A cross-sectional study

BACKGROUND

Access to clean water is important for menstrual hygiene practices, an important aspect of health for adolescent girls. In Bangladesh, adolescent girls represent poor menstrual hygiene practices, whereas the practice is worse among vulnerable population groups living in areas experiencing seasonal water scarcity. This study portrays perceived difficulties in menstrual hygiene practices among indigenous adolescent girls during the period of seasonal water scarcity in Bandarban Hill District, Bangladesh.

METHOD

Data was collected from 242 indigenous adolescent girls through interviews during the period of water scarcity. Backward stepwise regression model was used to identify factors associated with perceived difficulty in maintaining menstrual hygiene (PD) practices.

RESULT

The study participants, mainly living in hard-to-reach areas, reported difficulty in getting adequate water during the water scarcity period, and the quality of water was reported to be poor. PD due to water scarcity was found to be significantly associated with water source degradation (β = 0.247, < 0.001), the need for boiling/purifying water before use for menstrual hygiene (β = 0.203, p = 0.005), and experience of water availability when it was necessary to maintain their optimal menstrual hygiene practice (β = 0.449, p < 0.001), time required to collect water (β = 0.209, p < 0.001), taking a bath every day (β = -0.228, p < 0.001), and frequency of washing genitals per day (β = - 0.094, p = 0.040).

CONCLUSION

Indigenous adolescents perceive difficulty in menstrual hygiene practices during the period of water scarcity. Further research could be carried out to observe to what extent the seasonal water scarcity could be attributable to worsen the menstrual hygiene practices and to identify the need for addressing the problems.

"Impaired Resilience (00210)" in patients under fertility treatment: Clinical validation study

PURPOSE

The aim of this study was a clinical validation of the NANDA-I nursing diagnosis "Impaired Resilience (00210)" in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics.

METHODS

A cross-sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility-related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee.

FINDINGS

The "Impaired Resilience (00210)" had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are "decreased interest in vocational activities," "depression," "impaired health status," "ineffective coping strategies," "low self-esteem," "renewed elevation of distress," and "social isolation." No item showed differential item functioning. "Renewed elevation of distress" and "low self-esteem" were the most sensitive defining characteristics and had the highest negative predictive value. "Shame" was the most specific one.

CONCLUSIONS

The nursing diagnosis "Impaired Resilience (00210)" was validated, and results may improve its accuracy in people going through fertility treatment.

IMPLICATIONS FOR NURSING PRACTICE

This paper contributes by raising knowledge regarding NANDA-I nursing diagnosis and enhancing the quality of nurses' critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field.

“Spiritual distress (00060)” in patients under fertility treatment: Clinical validation study

PURPOSE

This study aimed to clinically validate the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in people under assisted reproductive technologies, and to determine the sensitivity, specificity, and predictive value of the defining characteristics.

METHODS

Cross-sectional study that was conducted between September 2019 and June 2020. Recruitment happened by invitation posted in fertility-related websites. Those who accepted to participate were asked to fill the consent form and the online questionnaire. Statistical analysis was based on Rasch's model. The study was approved by the Ethics Committee.

FINDINGS

The sample comprised 104 Portuguese individuals undergoing assisted reproductive techniques. The "Spiritual distress (00066)" was validated and 22 defining characteristics were confirmed as representative. No item showed differential item functioning. "Perceived suffering" was the most sensitive defining characteristic and had the highest negative predictive value. "Insufficient courage" had the highest positive predictive value, and "Anger toward power greater than self" was the most specific.

CONCLUSIONS

Results validated the presence of the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in a sample going through assisted reproductive technologies, improving accuracy of this nursing diagnosis in such population.

IMPLICATIONS FOR NURSING PRACTICE

This is a crucial step to raise the level of evidence of such nursing diagnosis and to increase the level of evidence on NANDA-I terminology. Furthermore, this study has contributed to raising the quality of nurse's critical judgement and clinical reasoning and allow an early spiritual and a more holistic and personalized patient-centered intervention in the reproductive field.

The Impact of Juvenile Drug Treatment Courts on Substance Use, Mental Health, and Recidivism: Results from a Multisite Experimental Evaluation

Juvenile Drug Treatment Courts (JDTC) emerged in the mid-1990s as a potential solution to concern about substance use among youth in the juvenile justice system (JJS). Despite substantial research, findings on the JDTC effectiveness for reducing recidivism and substance use remain inconsistent, hampered by methodological problems. In 2016, the Office of Juvenile Justice and Delinquency Prevention published research-based JDTC Guidelines for best practices, and funded technical assistance for implementation and a multisite national outcomes study among JDTCs implementing the Guidelines. Ten sites were originally selected for this study, with a JDTC and Traditional Juvenile Court (TJC) participating. In two sites, moderate- to high-risk youth were randomized to JDTC or TJC, and in eight sites, a regression discontinuity design assigned moderate- to high-risk youth to JDTC, and other youth to TJC. Findings from four sites with sufficient cases and follow-up rates indicated that JDTCs reduced cannabis use, increased access to mental health services, and reduced recidivism. However, the effects were small to moderate, with positive impacts mainly observed among high-risk youth. The impacts of JDTCs may have been attenuated because Guidelines implementation was inconsistent across courts, and some TJCs implemented elements of the Guidelines, blurring the distinction between JDTCs and TJCs.

Family Health Development in Life Course Research: A Scoping Review of Family Functioning Measures

BACKGROUND AND OBJECTIVES

Our objective is to identify common family functioning measurement tools and assess their compatibility with family-health development and life-course perspectives.

METHODS

Data sources include PubMed, ERIC, CINAHL, Families and Societies Worldwide, PsychInfo, Web of Science, PsychNet, and Health and Psychosocial Instruments. Title and abstract screening and full-text review of articles were conducted by multiple reviewers based on prespecified inclusion criteria. Data extraction focused on features of identified measurements tools, including: (1) name (2) domains of family functioning measured, (3) established psychometric properties, and (4) original context of psychometric evaluation (eg, details about the study sample).

RESULTS

Of the 50 measurement tools identified, 94% measured organizational patterns (eg, flexibility, connectedness, or resources), 46% measured belief systems (eg, making meaning of adversity, or positive outlook), and 54% measured communication processes (eg, open emotional sharing, or collaborative problem-solving).

CONCLUSIONS

Existing measures of family functioning can aid life-course researchers in understanding family processes as contexts for health and well-being. There also remain opportunities to refine or develop measures of family functioning more compatible with a life-course perspective that assess family processes (1) at various life stages; (2) with various backgrounds, identities, structures, and experiences; and (3) embedded in or impacted by various contexts that may facilitate or hinder family functioning.

Psychometric Properties of the Patient Activation Measure in Community-Dwelling Adults in Singapore

Introduction

Measuring health activation in general population using valid instruments is needed to facilitate the evaluation of health education and behavioral programs in community. The 13-item Patient Activation Measure was well validated in patients with different chronic diseases but rarely validated in general population. The objective of this study was to assess the psychometric properties of the Patient Activation Measure among community-dwelling adults in Singapore.

Methods

Data of participants having valid responses to the English-version measure (N = 824) were analyzed. The psychometric properties were assessed by demonstrating evidence for uni-dimensionality using Rasch Principal Component Analysis of Residuals, known-group validity, convergent and divergent validity, and internal consistency reliability using Cronbach’s alpha.

Results

The uni-dimensionality of the Patient Activation Measure was supported by the Rasch Principal Component Analysis of Residuals results. Participants having multimorbidity or polypharmacy and being inactive in physical activity had significantly lower activation scores. The activation score was positively and moderately correlated with health confidence measured by the Health Confidence Measure (r = .38, P < .001), and negatively and weakly correlated with depressive symptoms measured by the Patient Health Questionnaire (r = − .13, P < .001). The internal reliability was good with a Cronbach’s alpha of .82.

Conclusion

The 13-item Patient Activation Measure has acceptable construct validity and good internal consistency among community-dwelling adults. It is a potential instrument to measure health activation in this population. Further research is required to investigate the expansion of response options, validate the cut-off scores for the activation levels and examine the test-retest reliability and responsiveness.

The impact of Juvenile Drug Treatment Courts (JDTC) implementing Federal Evidence-Based Guidelines on recidivism and substance use: multisite Randomized Controlled Trial (RCT) and Regression Discontinuity (RDD) Designs

BACKGROUND

Juvenile drug treatment courts (JDTC) have struggled to define themselves since their inception in 1995. Early courts followed a format similar to adult drug courts, but these did not address the unique needs of juveniles, which led to the creation of 16 Strategies by a consensus panel of practitioners and researchers. But, like the first JDTCs, research with courts following these strategies failed to provide convincing evidence that this "model" was associated with significant reductions in recidivism or drug use. More recently, a new set of evidence-based guidelines were developed through meta-analyses commissioned by the Office of Juvenile Justice and Delinquency Prevention (OJJDP, 2016).

METHOD

OJJDP provided funding for a rigorous multi-site evaluation of the guidelines. This study protocol paper for the Juvenile Drug Treatment Court (JDTC) Guidelines Cross-Site Evaluation presents research designs for the comparison of youth outcomes from 10 JDTCs compared with 10 Traditional Juvenile Courts (TJCs) in the same jurisdictions. Two sites opted into a randomized controlled trial (RCT) and eight sites chose to follow a regression discontinuity design (RDD). Youth data are captured at baseline, and at 6- and 12-month follow-ups using an interview comprised of several standardized assessments. The youths' official records also are abstracted for recidivism and substance use information. The degree to which the evidence-based guidelines are implemented at each site is assessed via an in-depth court self-assessment collected at baseline and again 2 years later and via structured site visits conducted once during implementation.

DISCUSSION

As a field-based trial, using both RCT and RDD designs, findings will provide important, policy-relevant information regarding the implementation of the OJJDP evidence-based guidelines, including the degree to which JDTCs adopted and/or modified these practices, their relative impact on recidivism and substance use, as well as the degree to which JDTCs differ from TJCs. Specific inferences may be drawn about whether following or not following specific guidelines differentially impact youth outcomes, yielding recommendations about the translation of this information from research-to-practice for potentiating the broader adoption of these guidelines by JDTCs nationwide.

CLINICAL TRIALS REGISTRATION

This was not an NIH supported trial. The funder, OJJDP/NIJ, instead required publishing the design with even more information at https://www.ojp.gov/ncjrs/virtual-library/abstracts/juvenile-drug-treatment-court-jdtc-guidelines-cross-site-evaluation .

Development and pilot evaluation of the Cognition domain of the Hong Kong Comprehensive Assessment Scales for Toddlers

Purpose: To describe the development of the Cognition domain of the Hong Kong Comprehensive Assessment Scales for Toddlers (HKCAS-T).Methods: Participants included 345 toddlers aged 18-41 months, with 258 recruited from Maternal and Child Health Centers (MCHCs) and 87 with cognitive delay recruited from Child Assessment Centers (CACs). They were individually administered the 83-item pilot version by medical practitioners or educational psychologists between 2017 and 2019 in MCHCs and CACs in Hong Kong.Results: Rasch analysis results supported the unidimensionality of the pilot version, after removing six items. Analysis of covariance results indicated that both the 83-item version and the 77-item version could differentiate between children of different age groups, and children with typical development from children with cognitive delay. Internal consistency and interrater reliability were 0.90 or above.Conclusions: The Cognition domain of the HKCAS-T is a promising developmental assessment tool for the assessment of toddlers. Cognition assessment, preschool, Chinese.

Development of Gross Motor Evaluation for Children Aged 18 to 42 Months

PURPOSE

To test the reliability and validity of the gross motor items making up a new instrument, Hong Kong Comprehensive Assessment Scales for Toddlers (HKCAS-T) for quantifying gross motor development among children aged 18 to 42 months.

METHODS

The 37 items were administered to 330 children, including 258 typically developing children and 72 children with gross motor delay.

RESULTS

Rasch analyzes indicated that the fit statistics of the 37 items were within the acceptable range. The assessment was found able to differentiate between typically developing children and those with gross motor delay and among children of different ages. The raw score reliability (KR-20) was 0.94.

CONCLUSION

The new instrument is a promising alternative for assessing young children's gross motor development.

Rasch analysis of the anterior knee pain scale in adolescents with patellofemoral pain

OBJECTIVE

The aim of this study was to evaluate the Anterior Knee Pain Scale in a cohort of adolescents being treated conservatively for patellofemoral pain using Rasch analysis.

DESIGN

This is a psychometric study.

SETTING

Physical therapy clinics of a large pediatric hospital in Columbus, Ohio (United States).

SUBJECTS

A total of 646 adolescent patients with patellofemoral pain (76% female, 14.6 ± 1.6 years old).

INTERVENTION

Not applicable.

MAIN MEASURE

The Anterior Knee Pain Scale.

RESULTS

The median Anterior Knee Pain Scale score was 73 (interquartile range 64-81), with scores ranging from 7 to 100 on the 100-point scale. The Rasch person reliability for the Anterior Knee Pain Scale was 0.74 and the Cronbach's alpha was 0.75, representing an acceptable person reliability. Principal component analysis revealed a ratio of 5.2:1 demonstrating acceptable unidimensionality of the Anterior Knee Pain Scale. A significant misfit was observed in the item "Abnormal Painful Kneecap Movements" (Outfit Means Square 2.74, Infit Means Square 1.41). Ordering of item responses was unsatisfactory as only five of the 13 items demonstrated appropriate distinction between each of the responses. There was no differential item functioning for sex or age for all items of the Anterior Knee Pain Scale, based upon the criterion of ⩾ 0.5 logit difference.

CONCLUSION

The Anterior Knee Pain Scale does not meet interval-level measurement criteria and should be considered ordinal level data.

The Development of Chinese Version of Transcultural Nursing Self-Efficiency Scale: Using Rasch Model Analysis

Introduction: With the huge advances of globalization and urbanization, the nursing services in China are meeting the challenge of varied culture-specific needs in practices. Tools to measure transcultural sensitivity thus has great value in promoting transcultural nursing practices. Method: The Chinese version of Transcultural Nursing Self-Efficacy Scale (TSET-CV) was translated and validated with a sample of 2,346 nurses in China. Utilizing the analytical framework of the rating scale model, each item of the three subscales, namely the cognitive, practical, and effect subscale, was analyzed in terms of item analysis, item fitting, difficulty, reliability, item function, and validity. Results: The analysis suggested that 5-point Likert-type scale was more suitable than the 10-point Likert-type scale originally used. Item 27 and Item 79 showed deficient properties, which was deleted in the TSET-CV. The most accurate ranges measured by the TSET-CV matched the range of the distribution of the subjects' ability. Discussion: Unlike the classical test theory, the rating scale model based on the Rasch's model can provide sample-independent psychometric properties of items. The revised TSET-CV has great potential in diagnosing deficiency among nursing student in transcultural self-efficiency, which can promote the development of corresponding education strategies.

Work in progress: the progression of competence-based employability

Purpose

Employability and its components have received a lot of attention from scholars and practitioners. However, little is known about the interrelations between these different components of employability and how employees progress within their employability trajectories. Therefore, a model of such progression was constructed and tested using Van der Heijde and Van der Heijden’s (2006) employability measurement instrument. The paper aims to discuss these issues.

Design/methodology/approach

The propositions were tested empirically by applying a Rasch model using a sample of 167 Austrian business consultants.

Findings

The findings lend some support for the hypothesized progression model of employability. Specifically, the items measuring occupational expertise are largely located in the group of items that were relatively likely to be endorsed. Also, the items of personal flexibility and anticipation and optimization were, in general, less likely to be endorsed than the items of occupational expertise.

Research limitations/implications

The major thrust of this paper is a theoretical one. However, the empirical demonstration tentatively supports the proposed model, which implies that further, more robust longitudinal research in this direction may be a worthwhile endeavor.

Practical implications

By understanding which competences are important at which stage or across which stages of an individual’s career, career advisors and human resource management professionals can give more targeted advice concerning career management practices.

Originality/value

The present study contributes to the literature by investigating how employees may make progress within their employability trajectories.

Translation and cross language validation of Passionate Love Scale among adults in Lahore, Pakistan

Objective of the present study was to translate and cross language validate the Passionate Love Scale (PLS) from English language to Urdu language using forward-back translation (Brislin, 1976) procedure. It is developed by Hatfield and Sprecher (1986). It has 15 self-reported and uni-dimensional items, with 9 points rating scale ranges from 1 = not at all true to 9 = definitely true. Results showed high level of Cronbach’s alpha reliability coefficient α = 0.90, test retest reliability ranged from r = .73 to r = .96 (ps < .01), item total correlation varying from r = .50 to r = .74 (ps < .01) and factor loading ranged from .39 to .73. Item difficulty was determined through the Rasch scaling analysis and construct validity of the Urdu PLS secured the same one-dimensional factor structure of the English PLS by retaining 15 items. It showed that the Urdu PLS is reliable and valid tool to measure the cognitive, emotional and behavioral components of passionate love in Pakistani cultural context. Implications of the study were also discussed.

PREDICTORS OF RECIDIVISM OVER 3 YEARS AMONG SUBSTANCE-USING WOMEN RELEASED FROM JAIL

This study examines predictors of recidivism over 3 years for 624 women released from a county jail using a comprehensive range of standardized measures derived from gender-responsive and gender-neutral criminogenic recidivism models. Although more than a dozen factors were related to recidivism in the univariate analysis, the multivariate analysis shows that recidivism can be reliably predicted (area under the curve = 0.90) with just four factors: age, no custody of children, substance use frequency, and number of substance problems. Exploratory analysis of women who recidivated in post-release months 1 to 3, 4 to 12, and 13 to 36 revealed that the effects of several variables (age, super optimism, and number of weeks in the jail treatment program) were dependent on the time elapsed since release from jail, whereas others (substance use and custody) had persistent effects over time. These findings support the development of re-entry services tailored for female offenders who address both gender-responsive and gender-neutral criminogenic risk factors.

Reliability and validity of the revised Osteoporosis Knowledge Test

BACKGROUND AND PURPOSE

The purpose of this study was to test the psychometric properties of the Osteoporosis Knowledge Test (OKT) revised to incorporate recent evidence-based recommendations for bone health.

METHODS

The revised OKT was tested with 866 participants (mean age = 62.8 years +/- 8.5 years) in an online bone health study.

RESULTS

Based on Rasch analysis, there was evidence of internal consistency with an item separation index of 12.68 and a reliability score of .98. The person separation index was 2.06 with a reliability score of .81. The INFIT and OUTFIT mean-square statistics for items on both subscales all demonstrated good fit ranging from 0.71 to 1.40, except for 2 items that had low OUTFIT statistics.

CONCLUSIONS

The revised OKT provides sufficient reliability and construct validity.