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Bourke-Taylor HM, Cordier R, Pallant JF. Criterion Validity of the Child's Challenging Behavior Scale, Version 2 (CCBS-2). Am J Occup Ther 2017; 72:7201205010p1-7201205010p9. [PMID: 29280721 DOI: 10.5014/ajot.2018.023366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The Child's Challenging Behavior Scale, Version 2 (CCBS-2), measures maternal rating of a child's challenging behaviors that compromise maternal mental health. The CCBS-2, the Child Behavior Checklist (CBCL), and the Strengths and Difficulties Questionnaire (SDQ) were compared in a sample of typically developing young Australian children. METHOD Criterion validity was investigated by correlating the CCBS-2 with "gold standard" measures (CBCL and SDQ subscales). Data were collected in a cross-sectional survey of mothers (N = 336) of children ages 3-9 yr. RESULTS Correlations with the CBCL externalizing subscales demonstrated moderate (ρ = .46) to strong (ρ = .66) correlations. Correlations with the SDQ externalizing behaviors subscales were moderate (ρ = .35) to strong (ρ = .60). CONCLUSION The criterion validity established in this study strengthens the psychometric properties that support ongoing development of the CCBS-2 as an efficient tool that may identify children in need of further evaluation.
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Affiliation(s)
- Helen M Bourke-Taylor
- Helen M. Bourke-Taylor, PhD, is Associate Professor, Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia;
| | - Reinie Cordier
- Reinie Cordier, PhD, is Associate Professor, School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Bentley, Perth, Western Australia
| | - Julie F Pallant
- Julie F. Pallant, PhD, is Adjunct Associate Professor, Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
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Pallant JF, Haines HM, Green P, Toohill J, Gamble J, Creedy DK, Fenwick J. Assessment of the dimensionality of the Wijma delivery expectancy/experience questionnaire using factor analysis and Rasch analysis. BMC Pregnancy Childbirth 2016; 16:361. [PMID: 27871320 PMCID: PMC5117613 DOI: 10.1186/s12884-016-1157-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 11/14/2016] [Indexed: 12/04/2022] Open
Abstract
Background Fear of childbirth has negative consequences for a woman's physical and emotional wellbeing. The most commonly used measurement tool for childbirth fear is the Wijma Delivery Expectancy Questionnaire (WDEQ-A). Although originally conceptualized as unidimensional, subsequent investigations have suggested it is multidimensional. This study aimed to undertake a detailed psychometric assessment of the WDEQ-A; exploring the dimensionality and identifying possible subscales that may have clinical and research utility. Methods WDEQ-A was administered to a sample of 1410 Australian women in mid-pregnancy. The dimensionality of WDEQ-A was explored using exploratory (EFA) and confirmatory factor analysis (CFA), and Rasch analysis. Results EFA identified a four factor solution. CFA failed to support the unidimensional structure of the original WDEQ-A, but confirmed the four factor solution identified by EFA. Rasch analysis was used to refine the four subscales (Negative emotions: five items; Lack of positive emotions: five items; Social isolation: four items; Moment of birth: three items). Each WDEQ-A Revised subscale showed good fit to the Rasch model and adequate internal consistency reliability. The correlation between Negative emotions and Lack of positive emotions was strong, however Moment of birth and Social isolation showed much lower intercorrelations, suggesting they should not be added to create a total score. Conclusion This study supports the findings of other investigations that suggest the WDEQ-A is multidimensional and should not be used in its original form. The WDEQ-A Revised may provide researchers with a more refined, psychometrically sound tool to explore the differential impact of aspects of childbirth fear. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1157-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J F Pallant
- Department of Rural Health, The University of Melbourne, Graham St, Shepparton, Australia
| | - H M Haines
- Department of Rural Health, The University of Melbourne, Graham St, Shepparton, Australia.
| | - P Green
- Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - J Toohill
- Menzies Health Institute, Griffith University, Meadowbrook Queensland, Australia
| | - J Gamble
- Menzies Health Institute, Griffith University, Meadowbrook Queensland, Australia
| | - D K Creedy
- Menzies Health Institute, Griffith University, Meadowbrook Queensland, Australia
| | - J Fenwick
- Menzies Health Institute, Griffith University, Meadowbrook Queensland, Australia.,Gold Coast University Hospital Southport, Queensland, 4215, Australia
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Lambert SD, Clover K, Pallant JF, Britton B, King MT, Mitchell AJ, Carter G. Making Sense of Variations in Prevalence Estimates of Depression in Cancer: A Co-Calibration of Commonly Used Depression Scales Using Rasch Analysis. J Natl Compr Canc Netw 2016; 13:1203-11. [PMID: 26483060 DOI: 10.6004/jnccn.2015.0149] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The use of different depression self-report scales warrants co-calibration studies to establish relationships between scores from 2 or more scales. The goal of this study was to examine variations in measurement across 5 commonly used scales to measure depression among patients with cancer: Hospital Anxiety and Depression Scale-Depression subscale (HADS-D), Centre for Epidemiologic Studies Depression Scale (CES-D), Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory-II (BDI-II), and Depression Anxiety and Stress Scale-Depression subscale (DASS-D). METHODS The depression scales were completed by 162 patients with cancer. Participants were also assessed by the major depressive episode module of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Rasch analysis and receiver operating characteristic curves were performed. RESULTS Rasch analysis of the 5 scales indicated that these all measured depression. The HADS and BDI-II had the widest measurement range, whereas the DASS-D had the narrowest range. Co-calibration revealed that the cutoff scores across the scales were not equivalent. The mild cutoff score on the PHQ-9 was easier to meet than the mild cutoff score on the CES-D, BDI-II, and DASS-D. The HADS-D possible cutoff score was equivalent to cutoff scores for major to severe depression on the other scales. Optimal cutoff scores for clinical assessment of depression were in the mild to moderate depression range for most scales. CONCLUSIONS The labels of depression associated with the different scales are not equivalent. Most markedly, the HADS-D possible case cutoff score represents a much higher level of depression than equivalent scores on other scales. Therefore, use of different scales will lead to different estimates of prevalence of depression when used in the same sample.
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Affiliation(s)
- Sylvie D Lambert
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Kerrie Clover
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom. From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Julie F Pallant
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Benjamin Britton
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Madeleine T King
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Alex J Mitchell
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
| | - Gregory Carter
- From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom. From Ingram School of Nursing, McGill University, Montreal, Quebec, Canada; Psycho-Oncology Service, Calvary Mater Newcastle, New South Wales, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia; Rural Health Academic Centre, University of Melbourne, Victoria, Australia; School of Psychology and Sydney Medical School, University of Sydney, New South Wales, Australia; and University of Leicester, Cancer Studies & Molecular Medicine, Leicester, United Kingdom
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Robinson S, Kissane DW, Brooker J, Michael N, Fischer J, Franco M, Hempton C, Sulistio M, Pallant JF, Clarke DM, Burney S. Refinement and revalidation of the demoralization scale: The DS-II-internal validity. Cancer 2016; 122:2251-9. [DOI: 10.1002/cncr.30015] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/02/2016] [Accepted: 02/10/2016] [Indexed: 11/12/2022]
Affiliation(s)
- Sophie Robinson
- Department of Psychiatry, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
- School of Psychological Sciences; Monash University; Clayton Australia
| | - David W. Kissane
- Department of Psychiatry, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
- Szalmuk Family Psycho-oncology Unit; Cabrini Institute; Malvern Australia
- Cabrini Palliative Care Service; Cabrini Health; Prahran Australia
- Supportive and Palliative Care Unit; Monash Health; Clayton Australia
| | - Joanne Brooker
- Department of Psychiatry, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
- Szalmuk Family Psycho-oncology Unit; Cabrini Institute; Malvern Australia
| | - Natasha Michael
- Cabrini Palliative Care Service; Cabrini Health; Prahran Australia
- Department of Medicine, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
| | - Jane Fischer
- Department of Palliative Care, Calvary Health Care Bethlehem; Caulfield Australia
| | - Michael Franco
- Supportive and Palliative Care Unit; Monash Health; Clayton Australia
- Department of Medicine, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
| | - Courtney Hempton
- Department of Psychiatry, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
- Szalmuk Family Psycho-oncology Unit; Cabrini Institute; Malvern Australia
| | - Merlina Sulistio
- Cabrini Palliative Care Service; Cabrini Health; Prahran Australia
| | - Julie F. Pallant
- Department of Rural Health; The University of Melbourne; Melbourne Australia
| | - David M. Clarke
- Department of Psychiatry, School of Clinical Sciences at Monash Health; Monash University; Clayton Australia
| | - Susan Burney
- School of Psychological Sciences; Monash University; Clayton Australia
- Szalmuk Family Psycho-oncology Unit; Cabrini Institute; Malvern Australia
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Pallant JF, Dixon L, Sidebotham M, Fenwick J. Adaptation and psychometric testing of the Practice Environment Scale for use with midwives. Women Birth 2016; 29:24-9. [DOI: 10.1016/j.wombi.2015.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 07/08/2015] [Accepted: 07/22/2015] [Indexed: 10/23/2022]
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Haines HM, Pallant JF, Fenwick J, Gamble J, Creedy DK, Toohill J, Hildingsson I. Identifying women who are afraid of giving birth: A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort. Sex Reprod Healthc 2015; 6:204-10. [PMID: 26614602 DOI: 10.1016/j.srhc.2015.05.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/01/2015] [Accepted: 05/11/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND The WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice. AIM To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women. METHOD Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics. RESULTS 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean. CONCLUSION This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women.
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Affiliation(s)
- H M Haines
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Rural Health Academic Centre, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia; Northeast Health, Green St, Wangaratta, Victoria, Australia.
| | - J F Pallant
- Rural Health Academic Centre, The University of Melbourne, 49 Graham St, Shepparton, Victoria, Australia
| | - J Fenwick
- Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia; Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland 4215, Australia
| | - J Gamble
- Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
| | - D K Creedy
- Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
| | - J Toohill
- Griffith Health Institute and School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
| | - I Hildingsson
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
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Bourke-Taylor H, Lalor A, Farnworth L, Pallant JF, Knightbridge E, McLelland G. Investigation of the self-reported health and health-related behaviours of Victorian mothers of school-aged children. Aust J Prim Health 2015; 21:66-73. [PMID: 24134959 DOI: 10.1071/py13056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 08/27/2013] [Indexed: 11/23/2022]
Abstract
Lifestyle may influence many health-related issues currently facing Australian women. The extent to which women with school-aged children attend to their own health is unknown and the associations between health behaviours and health status requires investigation. This study aimed to investigate the prevalence of health behaviours (alcohol consumption, health-promoting activities) and their impact on self-reported health (weight, sleep quality, mental health) among mothers of school-aged children in Victoria. Mail-out survey design (n=263) including the Depression Anxiety Stress Scale (DASS) and Health Promoting Activities Scale was used to explore issues. The results indicated that substantial numbers of mothers reported moderate to extreme DASS scores: depression (n=45, 17%); anxiety (n=41, 15.6%); stress (n=57, 21.7%). The majority participated in physical activity less often than daily. High rates of daily alcohol use (20%) and poor sleep quality were reported. Nearly one-half (n=114, 46%) of the sample were overweight or obese and also reported poorer mental health than other women in the sample (P<0.001). Significant associations were detected between maternal weight, mental health and participation in health-promoting activities. The findings indicate that there is a need for increased health education and services for women with school-aged children. Direct services and population-based health promotion strategies may be required to address healthy lifestyle issues and educate mothers about the possible health legacy of poor health behaviours.
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Affiliation(s)
- Helen Bourke-Taylor
- Occupational Therapy Department, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University PO Box 527, Frankston, Vic. 3199, Australia
| | - Aislinn Lalor
- Occupational Therapy Department, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University PO Box 527, Frankston, Vic. 3199, Australia
| | - Louise Farnworth
- Occupational Therapy Department, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University PO Box 527, Frankston, Vic. 3199, Australia
| | - Julie F Pallant
- Griffith Health Institute, G40 Griffith Health Centre, Level 8.86, Gold Coast Campus, Griffith University, Qld 4222, Australia
| | - Elizabeth Knightbridge
- Occupational Therapy Department, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University PO Box 527, Frankston, Vic. 3199, Australia
| | - Gayle McLelland
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, PO Box 527, Frankston, Vic. 3199, Australia
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Rubertsson C, Pallant JF, Sydsjö G, Haines HM, Hildingsson I. Maternal depressive symptoms have a negative impact on prenatal attachment – findings from a Swedish community sample. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2014.992009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Costa DS, Aaronson NK, Fayers PM, Grimison PS, Janda M, Pallant JF, Rowen D, Velikova G, Viney R, Young TA, King MT. Deriving a preference-based utility measure for cancer patients from the European Organisation for the Research and Treatment of Cancer's Quality of Life Questionnaire C30: a confirmatory versus exploratory approach. Patient Relat Outcome Meas 2014; 5:119-29. [PMID: 25395875 PMCID: PMC4227619 DOI: 10.2147/prom.s68776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Multi attribute utility instruments (MAUIs) are preference-based measures that comprise a health state classification system (HSCS) and a scoring algorithm that assigns a utility value to each health state in the HSCS. When developing a MAUI from a health-related quality of life (HRQOL) questionnaire, first a HSCS must be derived. This typically involves selecting a subset of domains and items because HRQOL questionnaires typically have too many items to be amendable to the valuation task required to develop the scoring algorithm for a MAUI. Currently, exploratory factor analysis (EFA) followed by Rasch analysis is recommended for deriving a MAUI from a HRQOL measure. Aim To determine whether confirmatory factor analysis (CFA) is more appropriate and efficient than EFA to derive a HSCS from the European Organisation for the Research and Treatment of Cancer’s core HRQOL questionnaire, Quality of Life Questionnaire (QLQ-C30), given its well-established domain structure. Methods QLQ-C30 (Version 3) data were collected from 356 patients receiving palliative radiotherapy for recurrent/metastatic cancer (various primary sites). The dimensional structure of the QLQ-C30 was tested with EFA and CFA, the latter informed by the established QLQ-C30 structure and views of both patients and clinicians on which are the most relevant items. Dimensions determined by EFA or CFA were then subjected to Rasch analysis. Results CFA results generally supported the proposed QLQ-C30 structure (comparative fit index =0.99, Tucker–Lewis index =0.99, root mean square error of approximation =0.04). EFA revealed fewer factors and some items cross-loaded on multiple factors. Further assessment of dimensionality with Rasch analysis allowed better alignment of the EFA dimensions with those detected by CFA. Conclusion CFA was more appropriate and efficient than EFA in producing clinically interpretable results for the HSCS for a proposed new cancer-specific MAUI. Our findings suggest that CFA should be recommended generally when deriving a preference-based measure from a HRQOL measure that has an established domain structure.
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Affiliation(s)
- Daniel Sj Costa
- Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, NSW, Australia
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Peter M Fayers
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK ; Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Peter S Grimison
- Chris O'Brien Lifehouse, University of Sydney, Sydney, NSW, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Monika Janda
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Julie F Pallant
- Rural Health Academic Centre, University of Melbourne, Shepparton, VIC, Australia
| | - Donna Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Galina Velikova
- University of Leeds, St James's Institute of Oncology, Leeds, UK
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology, Sydney, NSW, Australia
| | - Tracey A Young
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Madeleine T King
- Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, NSW, Australia
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Darzins S, Imms C, Di Stefano M, Taylor NF, Pallant JF. Evaluation of the internal construct validity of the Personal Care Participation Assessment and Resource Tool (PC-PART) using Rasch analysis. BMC Health Serv Res 2014; 14:543. [PMID: 25371103 PMCID: PMC4226893 DOI: 10.1186/s12913-014-0543-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 10/21/2014] [Indexed: 12/02/2022] Open
Abstract
Background The Personal Care Participation Assessment and Resource Tool (PC-PART) is a 43-item, clinician-administered assessment, designed to identify patients’ unmet needs (participation restrictions) in activities of daily living (ADL) required for community life. This information is important for identifying problems that need addressing to enable, for example, discharge from inpatient settings to community living. The objective of this study was to evaluate internal construct validity of the PC-PART using Rasch methods. Methods Fit to the Rasch model was evaluated for 41 PC-PART items, assessing threshold ordering, overall model fit, individual item fit, person fit, internal consistency, Differential Item Functioning (DIF), targeting of items and dimensionality. Data used in this research were taken from admission data from a randomised controlled trial conducted at two publically funded inpatient rehabilitation units in Melbourne, Australia, with 996 participants (63% women; mean age 74 years) and with various impairment types. Results PC-PART items assessed as one scale, and original PC-PART domains evaluated as separate scales, demonstrated poor fit to the Rasch model. Adequate fit to the Rasch model was achieved in two newly formed PC-PART scales: Self-Care (16 items) and Domestic Life (14 items). Both scales were unidimensional, had acceptable internal consistency (PSI =0.85, 0.76, respectively) and well-targeted items. Conclusions Rasch analysis did not support conventional summation of all PC-PART item scores to create a total score. However, internal construct validity of the newly formed PC-PART scales, Self-Care and Domestic Life, was supported. Their Rasch-derived scores provided interval-level measurement enabling summation of scores to form a total score on each scale. These scales may assist clinicians, managers and researchers in rehabilitation settings to assess and measure changes in ADL participation restrictions relevant to community living. Trial registration Data used in this research were gathered during a registered randomised controlled trial: Australian and New Zealand Clinical Trials Registry ACTRN12609000973213. Ethics committee approval was gained for secondary analysis of data for this study.
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Phyland DJ, Pallant JF, Thibeault SL, Benninger MS, Vallance N, Smith JA. Measuring vocal function in professional music theater singers: construct validation of the Evaluation of the Ability to Sing Easily (EASE). Folia Phoniatr Logop 2014; 66:100-8. [PMID: 25341878 DOI: 10.1159/000366202] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OVERVIEW Working music theater singers (MTS) typically have a heavy vocal load and little is known about their perception of vocal function. The Evaluation of the Ability to Sing Easily (EASE) was used to assess professional MTS' perceptions of current singing voice status and to compare scores across demographic and performance characteristics and to evaluate the construct validity of the EASE and its subscales (VF = Vocal Fatigue, PRI = Pathologic-Risk Indicators). METHODS Professional MTS (n = 284) completed an online survey including the EASE and two additional Vocal Concern (VC) items. Scores were compared across age, gender, whether currently working, role, perceived vocal load over the past 24 h and self-reported voice problem. RESULTS For the whole cohort, statistically significant differences were found on all subscales according to whether or not singers perceived themselves to have a voice problem (p < 0.001). Currently performing singers were significantly different from those not performing in a show on the EASE Total (p = 0.014) and VF (p = 0.002), but not for PRI and VC. In the currently performing singer group, significant differences were found for gender, role and perceived voice problem on the EASE Total and all subscales (p < 0.01). Significantly higher VF scores were recorded for singers with heavy vocal load (p = 0.01), but there were no differences on the EASE Total (p = 0.57), PRI (p = 0.19) or VC subscales (p = 0.53). Among these performing singers, no significant age differences were found for any EASE subscales. CONCLUSIONS These findings provide further validation of the EASE as a useful tool for measuring singers' perceptions of vocal function and suggest that the subscales should be scored separately. Future evaluation of the EASE against objective clinical assessments (e.g., videostroboscopy) is recommended.
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Affiliation(s)
- Debra J Phyland
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia
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Bourke-Taylor H, Lalor A, Farnworth L, Pallant JF. Further validation of the Health Promoting Activities Scale with mothers of typically developing children. Aust Occup Ther J 2014; 61:308-15. [DOI: 10.1111/1440-1630.12137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Helen Bourke-Taylor
- Faculty of Health Sciences; School of Allied Health; Australian Catholic University; Fitzroy
| | - Aislinn Lalor
- Department of Occupational Therapy; School of Primary Health Care; Faculty of Medicine, Nursing and Health Sciences; Monash University; Frankston
| | - Louise Farnworth
- Department of Occupational Therapy; School of Primary Health Care; Faculty of Medicine, Nursing and Health Sciences; Monash University; Frankston
| | - Julie F. Pallant
- Rural Health Academic Centre; University of Melbourne; Shepparton Victoria Australia
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Randall M, Imms C, Carey LM, Pallant JF. Rasch analysis of The Melbourne Assessment of Unilateral Upper Limb Function. Dev Med Child Neurol 2014; 56:665-72. [PMID: 24494925 DOI: 10.1111/dmcn.12391] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2013] [Indexed: 11/30/2022]
Abstract
AIM This study investigated the internal construct validity and dimensionality of the Melbourne Assessment of Unilateral Upper Limb Function (Melbourne Assessment), a widely-used measure of quality of upper limb movement, valid for children aged 2 years 6 months to 15 years with cerebral palsy. METHOD Rasch analysis was used to assess of Melbourne Assessment raw scores for 163 children (94 males, 69 females; mean age 8y, SD 3y 5mo). Analysis was undertaken on the full scale comprising 37 scores and on groups of scores separated into four distinct movement subscales: range of movement, accuracy, dexterity, and fluency. Tests were conducted to evaluate overall model fit, item fit, suitability of the response options, unidimensionality, and differential item functioning (DIF) for sex, child age, and different raters. RESULTS The results did not support the unidimensionality of the 37-score scale. The four subscales showed adequate model fit after removal of some score items, and rescaling of others. The resulting subscales showed good internal consistency and no DIF for sex or child age. INTERPRETATION This study provides empirical support for a revised version of the Melbourne Assessment which comprises 14 tasks and 30 movement scores grouped across four separate subscales. Further testing is required to assess the responsiveness of subscales to clinically important change.
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Affiliation(s)
- Melinda Randall
- Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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Bourke-Taylor HM, Pallant JF, Law M. Update on the Child's Challenging Behaviour Scale following evaluation using Rasch analysis. Child Care Health Dev 2014; 40:242-9. [PMID: 23461777 DOI: 10.1111/cch.12035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Child's Challenging Behaviour Scale (CCBS) was designed to measure a mother's rating of her child's challenging behaviours. The CCBS was initially developed for mothers of school-aged children with developmental disability and has previously been shown to have good psychometric properties using classical test theory techniques. The aim of this study was to use Rasch analysis to fully evaluate all aspects of the scale, including response format, item fit, dimensionality and targeting. METHODS The sample consisted of 152 mothers of a school-aged child (aged 5-18 years) with a disability. Mothers were recruited via websites and mail-out newsletters through not-for-profit organizations that supported families with disabilities. Respondents completed a survey which included the 11 items of the CCBS. Rasch analysis was conducted on these responses using the RUMM2030 package. RESULTS Rasch analysis of the CCBS revealed serious threshold disordering for nine of the 11 items, suggesting problems with the 5-point response format used for the scale. The neutral midpoint of the response format was subsequently removed to create a 4-point scale. High levels of local dependency were detected among two pairs of items, resulting in the removal of two items (item 7 and item 1). The final nine-item version of the scale (CCBS Version 2) was unidimensional, well targeted, showed good fit to the Rasch model, and strong internal consistency. CONCLUSIONS To achieve fit to the Rasch model it was necessary to make two modifications to the CCBS scale. The resulting nine-item scale with a 4-point response format showed excellent psychometric properties, supporting its internal validity.
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Affiliation(s)
- H M Bourke-Taylor
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Vic., Australia
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Pallant JF, Haines HM, Hildingsson I, Cross M, Rubertsson C. Psychometric evaluation and refinement of the Prenatal Attachment Inventory. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2013.871627] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bourke-Taylor H, Pallant JF, Law M, Howie L. Relationships between sleep disruptions, health and care responsibilities among mothers of school-aged children with disabilities. J Paediatr Child Health 2013; 49:775-82. [PMID: 23745960 DOI: 10.1111/jpc.12254] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2012] [Indexed: 11/25/2022]
Abstract
AIM Sleep problems are more common among children with disabilities. Mothers are likely to provide night-time care. Mothers of children with disabilities are known to experience high levels of stress and mental health issues compared with other mothers. Relationships between a child's sleep problems, and chronic maternal sleep interruption and subjective health have not been researched. METHOD Cross-sectional mail-out survey with follow-up phone call was used. Instruments included the Short Form 36 version 2 and instruments that measured maternal, child and sleep characteristics. Descriptive statistics examined characteristics of participants and correlation, and Kruskal-Wallis test was used to determine important maternal and child characteristics around sleep issues. RESULTS All mothers (n = 152) cared for a school-aged child with a developmental disability including autism spectrum disorder (n = 94) and cerebral palsy (n = 29). Nearly half (49%) of the mothers were awoken more than 4 nights/week. Three distinct sleep groups were identified: no sleep interruption; sleep interruption once/night, 4 nights/week; and more frequent interruption. Mothers experiencing the most sleep interruptions reported significantly poorer health on six Short Form 36 version 2 dimensions. Night-time caregiving was associated with higher child care needs rather than children's diagnoses. Mothers who experienced more sleep interruption also participated less in health-promoting activities (active leisure, time with socially supportive others) during the day. CONCLUSION This study identifies a group of mothers with chronic sleep interruption and demonstrates related poor maternal subjective health and lower participation in health activities that may service to support maternal health. Mothers with children with the highest daytime care needs also experienced high night-time care responsibilities. Changes to service provision are recommended to identify mothers in need of additional supports and services.
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Affiliation(s)
- Helen Bourke-Taylor
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Australia
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Bourke-Taylor H, Pallant JF. The Assistance to Participate Scale to measure play and leisure support for children with developmental disability: update following Rasch analysis. Child Care Health Dev 2013; 39:544-51. [PMID: 23763255 DOI: 10.1111/cch.12047] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Assistance to Participate Scale (APS) was designed to measure the primary carer's estimate of the amount of assistance that their school-aged child with a disability requires to participate in play and leisure activities. Previous research suggests that the 8-item APS has good internal consistency. The construct validity of the scale is supported by strong correlations with instruments measuring similar constructs and discrimination between groups of children with developmental disability, based on extent of need for caregiver assistance. AIM The aim of this current study was to undertake further evaluation of the psychometric properties of the APS using Rasch analysis. METHOD Rasch analysis was conducted using the RUMM2030 program to assess the APS items in terms of their overall fit to the Rasch model, individual item fit, response format, targeting and dimensionality. RESULTS Rasch analysis showed good fit to the model, with no misfitting items and good internal consistency (PSI = 0.85). There was no differential item functioning across mothers' age, education level or child's age. Dimensionality testing supported the combination of all items to create a total score. Most items showed disordered thresholds, suggesting some inconsistencies in the way respondents used the response scale options. CONCLUSIONS The APS has been subjected to substantial psychometric testing during development and evaluation, revealing a sound, brief and easy-to-use scale. The APS has a number of potential clinical and research uses measuring the amount of additional assistance that children require from their primary care giver to participate in play activities.
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Affiliation(s)
- H Bourke-Taylor
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Frankston, Vic., Australia.
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Amatya B, Khan F, Whishaw M, Pallant JF. Guillain-Barré syndrome: prevalence and long-term factors impacting bladder function in an Australian community cohort. J Clin Neurol 2013; 9:144-50. [PMID: 23894237 PMCID: PMC3722465 DOI: 10.3988/jcn.2013.9.3.144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 01/29/2013] [Accepted: 01/29/2013] [Indexed: 01/04/2023] Open
Abstract
Background and Purpose Urinary dysfunction is associated with significant morbidity in persons with Guillain-Barré Syndrome (GBS). The aim of this study was to describe prevalence and long-term impact of bladder dysfunction on daily activities and quality of life (QoL) in persons in chronic phase of GBS and to examine the relationships between commonly used continence measures in this cohort. Methods Prospective cohort (n=66) following GBS treatment (1996-2009) was recruited from a tertiary hospital and assessed using standardised measures for bladder dysfunction: American Urological Association (AUA) Symptom Index, Incontinence Impact Questionnaire, Urogenital Distress Inventory. Results Sixty-six participants (64% male, mean age 56 years, median disease duration of 6.1 years) completed the study. Of these more than half reported nocturia and one-third reported urinary urgency and frequency. Urinary problems impacted on participants' daily activities: physical recreation (21%), emotional health and mood (17%), entertainment (14%), participation and mobility (>30 min) (12%), and performance of household chores (8%). Since GBS, 49% reported interference of urinary symptoms with daily life to some extent; and adverse impact on QoL (10.6%). Significant relationship between bladder symptoms; and the level of urogenital distress (p<0.001) and the impact of urinary problems (p<0.001), was noted. Higher scores on the bladder scales showed significant correlations with psychological, functional and participation scales. The single QoL item (AUA scale) correlated significantly with all other bladder scales (rho=0.63-0.86). This can be a potential 'screening tool' to identify patients for further assessment. Conclusions Bladder dysfunction in chronic phase of GBS is not well studied. More research in longer-term screening and outcomes for bladder intervention are needed for integrated care and to guide treating clinicians.
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Affiliation(s)
- Bhasker Amatya
- Department of Rehabilitation Medicine, Royal Melbourne Hospital, Victoria, Australia
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19
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Pallant JF, Reid C. Measuring the positive and negative aspects of the caring role in community versus aged care setting. Australas J Ageing 2013; 33:244-9. [DOI: 10.1111/ajag.12046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Julie F Pallant
- Rural Health Academic Centre; University of Melbourne; Shepparton Victoria Australia
| | - Carol Reid
- Carer Support Services; Family Care; Rural Health Academic Centre; University of Melbourne; Shepparton Victoria Australia
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Haines HM, Hildingsson I, Pallant JF, Rubertsson C. The role of women's attitudinal profiles in satisfaction with the quality of their antenatal and intrapartum care. J Obstet Gynecol Neonatal Nurs 2013; 42:428-41. [PMID: 23773005 DOI: 10.1111/1552-6909.12221] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. DESIGN Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of the quality of care was measured using the Quality from Patient's Perspective index at 34 to 36 weeks pregnancy and 2 months after birth. SETTING Two hospitals in Sweden and Australia. PARTICIPANTS Five hundred and five (505) pregnant women from one hospital in Västernorrland, Sweden (n = 386) and one in northeast Victoria, Australia (n = 123). RESULTS Women were categorized into three profiles: self-determiners, take it as it comes, and fearful. The self-determiners reported the best outcomes, whereas the fearful were most likely to perceive deficient care. Antenatally the fearful were more likely to indicate deficiencies in medical care, emotional care, support received from nurse-midwives or doctors and nurse-midwives'/doctors' understanding of the woman's situation. They also reported deficiencies in two aspects of intrapartum care: support during birth and control during birth. CONCLUSIONS Attitudinal profiling of women during pregnancy may assist clinicians to deliver the style and content of antenatal and intrapartum care to match what women value and need. An awareness of a woman's fear of birth provides an opportunity to offer comprehensive emotional support with the aim of promoting a positive birth experience.
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Affiliation(s)
- Helen M Haines
- Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Akademiskasjukhuset, Uppsala, Sweden.
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Lambert SD, Pallant JF, Boyes AW, King MT, Britton B, Girgis A. A Rasch analysis of the Hospital Anxiety and Depression Scale (HADS) among cancer survivors. Psychol Assess 2013; 25:379-90. [PMID: 23356678 DOI: 10.1037/a0031154] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The Hospital Anxiety and Depression Scale (HADS) is commonly used to assess distress among individuals with cancer. However, previous studies cast doubt on the most appropriate dimensional structure for the HADS, suggesting that 1- or 3-dimensional structures might offer superior fit to the original 2-dimensional one. This article is the first to use Rasch analysis to examine the psychometric properties of the subscales corresponding to each of these alternative structures. METHOD The HADS was completed by 1,360 cancer survivors. Rasch analyses were conducted to examine summary and individual model fit statistics, person separation index, response format, item bias, redundancy, and dimensionality. RESULTS The HADS-Total scale was found to be multidimensional, and it was necessary to remove almost half of the items to achieve fit. Analyses only partially supported the original structure, as both HADS-Anxiety and HADS-Depression showed initial model misfit and item deletion was necessary to achieve fit. Within the 3-dimensional structures, the Rasch statistics for the anxiety subscales were within acceptable range and no adjustment was needed. Analyses did not support adding Item 7 to HADS-Depression. CONCLUSIONS Results supported modified versions of the HADS-Anxiety and HADS-Depression; however, combining all items to form HADS-Total is not recommended. Numerous studies using classical test theory and Rasch analyses have corroborated the exclusion of some items (e.g., Item 7) and appropriateness of the subscales defined by a 3-dimensional structure. Further research is required to identify the incremental validity of potential revised subscales.
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Affiliation(s)
- Sylvie D Lambert
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales
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Amatya B, Khan F, Whishaw M, Pallant JF. Erratum: Guillain-Barré Syndrome: Prevalence and Long-Term Factors Impacting Bladder Function in an Australian Community Cohort. J Clin Neurol 2013. [PMCID: PMC3840142 DOI: 10.3988/jcn.2013.9.4.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Bhasker Amatya
- Department of Rehabilitation Medicine, Royal Melbourne Hospital, Victoria, Australia
| | - Fary Khan
- Department of Rehabilitation Medicine, Royal Melbourne Hospital, Victoria, Australia
- Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Michael Whishaw
- Royal Park Continence Service, Royal Melbourne Hospital, Victoria, Australia
| | - Julie F. Pallant
- Rural Health Academic Centre, University of Melbourne, Victoria, Australia
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Bourke-Taylor H, Pallant JF, Law M, Howie L. Predicting mental health among mothers of school-aged children with developmental disabilities: the relative contribution of child, maternal and environmental factors. Res Dev Disabil 2012; 33:1732-40. [PMID: 22699247 DOI: 10.1016/j.ridd.2012.04.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 04/14/2012] [Accepted: 04/16/2012] [Indexed: 05/26/2023]
Abstract
AIM Many mothers of children with developmental disabilities are known to experience high levels of stress, and compromised mental health. Research is crucial to better understand and assist mothers with compromised mental health, and ultimately better service families raising and supporting a child with a disability. METHOD Data were collected using cross sectional mail-out survey with follow up phone call. Instruments included the Short Form 36 version 2 (SF-36v2) and instruments that measured maternal, child and environmental factors. Descriptive statistics examined characteristics of participants. Correlation, t-tests, and multiple regression analyses were used to identify factors associated with mothers' mental health. RESULTS Mothers (N=152) cared for a school-aged child (aged 5-18 years) with high care needs and developmental disabilities including autism spectrum disorder (n=94); cerebral palsy (n=29); attention deficit hyperactivity disorder (n=19). Factors associated with maternal mental health included the child's psychosocial health (r=.36) and challenging behaviour (r=-.33); maternal empowerment (r=.40); maternal participation in health promoting activities (r=.43); and the child's unmet service needs (r=-.29). The strongest predictors of maternal mental health in this cross sectional study were maternal participation in healthy activity and empowerment, the child's emotional functioning and unmet service needs. CONCLUSION This study identified maternal factors as the most important influence on self reported mental health among this sample of mothers. Findings suggest that service changes that provide mothers with information about their own health and need for health enhancing activities, as well as education that empowers mothers to manage and master their child's disability and needs, may contribute to maternal mental health and well being.
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Affiliation(s)
- Helen Bourke-Taylor
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, PO Box 527, Frankston, Victoria 3199, Australia.
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Haines HM, Rubertsson C, Pallant JF, Hildingsson I. The influence of women's fear, attitudes and beliefs of childbirth on mode and experience of birth. BMC Pregnancy Childbirth 2012; 12:55. [PMID: 22727217 PMCID: PMC3449179 DOI: 10.1186/1471-2393-12-55] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 06/14/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women's fears and attitudes to childbirth may influence the maternity care they receive and the outcomes of birth. This study aimed to develop profiles of women according to their attitudes regarding birth and their levels of childbirth related fear. The association of these profiles with mode and outcomes of birth was explored. METHODS Prospective longitudinal cohort design with self report questionnaires containing a set of attitudinal statements regarding birth (Birth Attitudes Profile Scale) and a fear of birth scale (FOBS). Pregnant women responded at 18-20 weeks gestation and two months after birth from a regional area of Sweden (n = 386) and a regional area of Australia (n = 123). Cluster analysis was used to identify a set of profiles. Odds ratios (95% CI) were calculated, comparing cluster membership for country of care, pregnancy characteristics, birth experience and outcomes. RESULTS Three clusters were identified - 'Self determiners' (clear attitudes about birth including seeing it as a natural process and no childbirth fear), 'Take it as it comes' (no fear of birth and low levels of agreement with any of the attitude statements) and 'Fearful' (afraid of birth, with concerns for the personal impact of birth including pain and control, safety concerns and low levels of agreement with attitudes relating to women's freedom of choice or birth as a natural process). At 18 -20 weeks gestation, when compared to the 'Self determiners', women in the 'Fearful' cluster were more likely to: prefer a caesarean (OR = 3.3 CI: 1.6-6.8), hold less than positive feelings about being pregnant (OR = 3.6 CI: 1.4-9.0), report less than positive feelings about the approaching birth (OR = 7.2 CI: 4.4-12.0) and less than positive feelings about the first weeks with a newborn (OR = 2.0 CI 1.2-3.6). At two months post partum the 'Fearful' cluster had a greater likelihood of having had an elective caesarean (OR = 5.4 CI 2.1-14.2); they were more likely to have had an epidural if they laboured (OR = 1.9 CI 1.1-3.2) and to experience their labour pain as more intense than women in the other clusters. The 'Fearful' cluster were more likely to report a negative experience of birth (OR = 1.7 CI 1.02- 2.9). The 'Take it as it comes' cluster had a higher likelihood of an elective caesarean (OR 3.0 CI 1.1-8.0). CONCLUSIONS In this study three clusters of women were identified. Belonging to the 'Fearful' cluster had a negative effect on women's emotional health during pregnancy and increased the likelihood of a negative birth experience. Both women in the 'Take it as it comes' and the 'Fearful' cluster had higher odds of having an elective caesarean compared to women in the 'Self determiners'. Understanding women's attitudes and level of fear may help midwives and doctors to tailor their interactions with women.
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Affiliation(s)
- Helen M Haines
- Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, 751 85, Uppsala, Sweden.
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Burns J, Ouvrier R, Estilow T, Shy R, Laurá M, Pallant JF, Lek M, Muntoni F, Reilly MM, Pareyson D, Acsadi G, Shy ME, Finkel RS. Validation of the Charcot-Marie-Tooth disease pediatric scale as an outcome measure of disability. Ann Neurol 2012; 71:642-52. [PMID: 22522479 DOI: 10.1002/ana.23572] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Charcot-Marie-Tooth disease (CMT) is a common heritable peripheral neuropathy. There is no treatment for any form of CMT, although clinical trials are increasingly occurring. Patients usually develop symptoms during the first 2 decades of life, but there are no established outcome measures of disease severity or response to treatment. We identified a set of items that represent a range of impairment levels and conducted a series of validation studies to build a patient-centered multi-item rating scale of disability for children with CMT. METHODS As part of the Inherited Neuropathies Consortium, patients aged 3 to 20 years with a variety of CMT types were recruited from the USA, United Kingdom, Italy, and Australia. Initial development stages involved definition of the construct, item pool generation, peer review, and pilot testing. Based on data from 172 patients, a series of validation studies were conducted, including item and factor analysis, reliability testing, Rasch modeling, and sensitivity analysis. RESULTS Seven areas for measurement were identified (strength, dexterity, sensation, gait, balance, power, endurance), and a psychometrically robust 11-item scale was constructed (CMT Pediatric Scale [CMTPedS]). Rasch analysis supported the viability of the CMTPedS as a unidimensional measure of disability in children with CMT. It showed good overall model fit, no evidence of misfitting items, and no person misfit, and it was well targeted for children with CMT. INTERPRETATION The CMTPedS is a well-tolerated outcome measure that can be completed in 25 minutes. It is a reliable, valid, and sensitive global measure of disability for children with CMT from the age of 3 years.
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Affiliation(s)
- Joshua Burns
- Children's Hospital at Westmead and University of Sydney, Australia.
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Zucca A, Lambert SD, Boyes AW, Pallant JF. Rasch analysis of the Mini-Mental Adjustment to Cancer Scale (mini-MAC) among a heterogeneous sample of long-term cancer survivors: a cross-sectional study. Health Qual Life Outcomes 2012; 10:55. [PMID: 22607052 PMCID: PMC3487859 DOI: 10.1186/1477-7525-10-55] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 05/03/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The mini-Mental Adjustment to Cancer Scale (mini-MAC) is a well-recognised, popular measure of coping in psycho-oncology and assesses five cancer-specific coping strategies. It has been suggested that these five subscales could be grouped to form the over-arching adaptive and maladptive coping subscales to facilitate the interpretation and clinical application of the scale. Despite the popularity of the mini-MAC, few studies have examined its psychometric properties among long-term cancer survivors, and further validation of the mini-MAC is needed to substantiate its use with the growing population of survivors. Therefore, this study examined the psychometric properties and dimensionality of the mini-MAC in a sample of long-term cancer survivors using Rasch analysis. METHODS RUMM 2030 was used to analyse the mini-MAC data (n=851). Separate Rasch analyses were conducted for each of the original mini-MAC subscales as well as the over-arching adaptive and maladaptive coping subscales to examine summary and individual model fit statistics, person separation index (PSI), response format, local dependency, targeting, item bias (or differential item functioning -DIF), and dimensionality. RESULTS For the fighting spirit, fatalism, and helplessness-hopelessness subscales, a revised three-point response format seemed more optimal than the original four-point response. To achieve model fit, items were deleted from four of the five subscales - Anxious Preoccupation items 7, 25, and 29; Cognitive Avoidance items 11 and 17; Fighting Spirit item 18; and Helplessness-Hopelessness items 16 and 20. For those subscales with sufficient items, analyses supported unidimensionality. Combining items to form the adaptive and maladaptive subscales was partially supported. CONCLUSIONS The original five subscales required item deletion and/or rescaling to improve goodness of fit to the Rasch model. While evidence was found for overarching subscales of adaptive and maladaptive coping, extensive modifications were necessary to achieve this result. Further exploration and validation of over-arching subscales assessing adaptive and maladaptive coping is necessary with cancer survivors.
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Affiliation(s)
- Alison Zucca
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour School of Medicine & Public Health, University of Newcastle, Room 230A, Level 2, David Maddison Building, Callaghan, NSW, 2308, Australia
| | - Sylvie D Lambert
- Translational Cancer Research Unit, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School The University of New South Wales, Liverpool, Australia
| | - Allison W Boyes
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, University of Newcastle & Hunter Medical Research Institute, Newcastle, NSW, Australia
- Priority Research Centre for Health Behaviour School of Medicine & Public Health, University of Newcastle, Room 230A, Level 2, David Maddison Building, Callaghan, NSW, 2308, Australia
| | - Julie F Pallant
- Rural Health Academic Centre, University of Melbourne, 49 Graham St, Shepparton, VIC, 3630, Australia
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Mills RJ, Pallant JF, Koufali M, Sharma A, Day S, Tennant A, Young CA. Validation of the Neurological Fatigue Index for stroke (NFI-Stroke). Health Qual Life Outcomes 2012; 10:51. [PMID: 22587411 PMCID: PMC3485136 DOI: 10.1186/1477-7525-10-51] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 04/26/2012] [Indexed: 11/10/2022] Open
Abstract
Background Fatigue is a common symptom in Stroke. Several self-report scales are available to measure this debilitating symptom but concern has been expressed about their construct validity. Objective To examine the reliability and validity of a recently developed scale for multiple sclerosis (MS) fatigue, the Neurological Fatigue Index (NFI-MS), in a sample of stroke patients. Method Six patients with stroke participated in qualitative interviews which were analysed and the themes compared for equivalence to those derived from existing data on MS fatigue. 999 questionnaire packs were sent to those with a stroke within the past four years. Data from the four subscales, and the Summary scale of the NFI-MS were fitted to the Rasch measurement model. Results Themes identified by stroke patients were consistent with those identified by those with MS. 282 questionnaires were returned and respondents had a mean age of 67.3 years; 62% were male, and were on average 17.2 (SD 11.4, range 2–50) months post stroke. The Physical, Cognitive and Summary scales all showed good fit to the model, were unidimensional, and free of differential item functioning by age, sex and time. The sleep scales failed to show adequate fit in their current format. Conclusion Post stroke fatigue appears to be represented by a combination of physical and cognitive components, confirmed by both qualitative and quantitative processes. The NFI-Stroke, comprising a Physical and Cognitive subscale, and a 10-item Summary scale, meets the strictest measurement requirements. Fit to the Rasch model allows conversion of ordinal raw scores to a linear metric.
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Affiliation(s)
- Roger J Mills
- The Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
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Birnbrauer JS, Yardley P, Pallant JF. A Fresh AppraisalB.F. Skinner Davidson Films. (1999). [Video]. (Available from 668 Marsh Street, San Luis Obispo, CA 93401. (805) 594-0422. www.davidsonfilms.com] 41 minutes; $250. - Casebook in Child Behavior DisordersC. Kearney (1999). Belmont, USA: Wadsworth. 226 pp.; paperback $41-95. - Research in Psychology: Methods and Design (2nd edition)C. James Goodwin (1998). New York: Wiley. 528 pp.; $122.95. Behav change 2012. [DOI: 10.1375/bech.16.4.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Khan F, Amatya B, Pallant JF, Rajapaksa I. Factors associated with long-term functional outcomes and psychological sequelae in women after breast cancer. Breast 2012; 21:314-20. [PMID: 22342676 DOI: 10.1016/j.breast.2012.01.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 01/23/2012] [Accepted: 01/24/2012] [Indexed: 11/27/2022] Open
Abstract
The objective of this study was to examine factors impacting long-term functional outcomes and psychological sequelae in survivors of breast cancer (BC). A clinical assessment and structured interview assessed the impact of BC on participants' (n=85) current activity and restriction in participation, using validated questionnaires: Functional Independence Measure (FIM), Perceived Impact Problem Profile (PIPP) and Depression Anxiety Stress Scale (DASS). Participants showed good functional recovery (median motor FIM score=78). Three-quarters (74%) reported pain, 32% reported upper limb weakness, 31% pain limiting shoulder movement and 29% lymphoedema. One third (32%) reported greatest impact on psychological wellbeing. A substantial number of participants reported high levels of depression (22%), anxiety and stress (19% each). Factors associated with poorer current level of functioning and wellbeing included: younger participants, recent diagnoses, aggressive tumour types, receiving chemotherapy, shoulder limitation due to pain, and lymphoedema. BC survivors require long-term management of psychological sequelae impacting activity and participation.
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Affiliation(s)
- Fary Khan
- Department of Medicine, Dentistry & Health Sciences, University of Melbourne, Grattan Street, Parkville, VIC 3050, Australia.
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Bourke-Taylor H, Howie L, Law M, Pallant JF. Self-reported mental health of mothers with a school-aged child with a disability in Victoria: a mixed method study. J Paediatr Child Health 2012; 48:153-9. [PMID: 21470330 DOI: 10.1111/j.1440-1754.2011.02060.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This research investigated the mental health of mothers of school-aged children with disabilities in Victoria, Australia. METHODS A mixed method triangulation design model was used to investigate the mental health of mothers (n= 152) of school-aged children with developmental disabilities. Self-reported medical history and completion of the Short Form Health Survey Version 2 were used to collect data via mail-out survey and follow-up phone interview. RESULTS Mothers reported subjective mental health two standard deviations below other Australians and higher rates of depression and anxiety that other Australian women and the adult population in general. Half of participants reported that their health affected their ability to provide the care that their child needed, and half experienced frequent interrupted sleep secondary to the care of their child with a disability. Significantly poorer mental health was reported by mothers with a pre-school-aged child as well as a child with a disability (P < 0.001), mothers with more than one child with a disability (P= 0.038), mothers of children with autism spectrum disorder (ASD) (P= 0.026), and mothers who recognised that their health affected care giving (P < 0.001). CONCLUSIONS The reported mental health of participants in this study indicates that further attention is needed to action health strategies to support mothers of children with disabilities. Health programs and policy that will identify mothers in need of assistance, as well as management strategies that will adequately support mental wellness in mothers is required in Australia.
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Affiliation(s)
- Helen Bourke-Taylor
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Australia.
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Covic T, Cumming SR, Pallant JF, Manolios N, Emery P, Conaghan PG, Tennant A. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS). BMC Psychiatry 2012; 12:6. [PMID: 22269280 PMCID: PMC3285517 DOI: 10.1186/1471-244x-12-6] [Citation(s) in RCA: 163] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 01/24/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. METHODS Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. RESULTS A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. CONCLUSIONS This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.
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Affiliation(s)
- Tanya Covic
- School of Psychology, University of Western Sydney, Australia
- School of Medicine, University of Sydney, Australia
| | | | - Julie F Pallant
- Rural Health Academic Centre, University of Melbourne, Australia
| | | | - Paul Emery
- Leeds Institute of Molecular Medicine, Section of Musculoskeletal Disease, Faculty of Medicine and Health, University of Leeds, UK
| | - Philip G Conaghan
- Leeds Institute of Molecular Medicine, Section of Musculoskeletal Disease, Faculty of Medicine and Health, University of Leeds, UK
| | - Alan Tennant
- Leeds Institute of Molecular Medicine, Section of Musculoskeletal Disease, Faculty of Medicine and Health, University of Leeds, UK
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Walker JH, Dewitt DE, Pallant JF, Cunningham CE. Rural origin plus a rural clinical school placement is a significant predictor of medical students' intentions to practice rurally: a multi-university study. Rural Remote Health 2012; 12:1908. [PMID: 22239835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Health workforce shortages are a major problem in rural areas. Australian medical schools have implemented a number of rural education and training interventions aimed at increasing medical graduates' willingness to work in rural areas. These initiatives include recruiting students from rural backgrounds, delivering training in rural areas, and providing all students with some rural exposure during their medical training. However there is little evidence regarding the impact of rural exposure versus rural origin on workforce outcomes. The aim of this study is to identify and assess factors affecting preference for future rural practice among medical students participating in the Australian Rural Clinical Schools (RCS) Program. METHODS Questionnaires were distributed to 166 medical students who had completed their RCS term in 2006; 125 (75%) responded. Medical students were asked about their preferred location and specialty for future practice, their beliefs about rural work and life, and the impact of the RCS experience on their future rural training and practice preferences. RESULTS Almost half the students (47%; n=58) self-reported a 'rural background'. Significantly, students from rural backgrounds were 10 times more likely to prefer to work in rural areas when compared with other students (p<0.001). For those preferring general practice, 80% (n=24) wished to do so rurally. Eighty-five per cent (n=105) of students agreed that their RCS experience increased their interest in rural training and practice with 62% (n=75) of students indicating a preference for rural internship/basic training after their RCS experience. A substantial percentage (86%; n=108) agreed they would consider rural practice after their RCS experience. CONCLUSIONS This baseline study provides significant evidence to support rural medical recruitment and retention through education and training, with important insights into the factors affecting preference for future rural practice. By far the most significant predictor of rural practice intention is recruitment of students with a rural background who also undertake an RCS placement. This research also demonstrates significant demand for post-graduate rural training places, including specialty places, as RCS graduates become junior doctors and vocational trainees.
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Bourke-Taylor H, Law M, Howie L, Pallant JF. Initial Development of the Health Promoting Activities Scale to Measure the Leisure Participation of Mothers of Children With Disabilities. Am J Occup Ther 2012. [DOI: 10.5014/ajot.2012.000521] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. The Health Promoting Activities Scale (HPAS) measures the frequency with which mothers participate in self-selected leisure activities that promote health and well-being. We undertook an initial evaluation of the scale with mothers of school-age children with developmental disabilities (N = 152).
METHOD. We used a mixed methodology in the instrument design: a qualitative study to generate items and a quantitative study to evaluate the instrument. Our statistical analysis assessed the internal consistency, factor structure, and construct validity of the HPAS.
RESULTS. The HPAS showed good internal consistency (Cronbach’s α = .78). Construct validity was supported by moderate correlations with subjective maternal mental and general health (Short Form 36, Version 2) and by differentiation in leisure participation among groups of mothers reporting differences in mental health status.
CONCLUSION. Initial evaluation of the HPAS indicates that this brief tool is psychometrically sound. The HPAS allows professionals to evaluate clients’ participation in leisure occupations that promote health and well-being. Further development of the HPAS is warranted.
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Affiliation(s)
- Helen Bourke-Taylor
- Helen Bourke-Taylor, PhD, MS OT, is Senior Lecturer, Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University–Peninsula Campus, PO Box 527, Frankston, Victoria 3199 Australia;
| | - Mary Law
- Mary Law, PhD, is Professor, School of Rehabilitation Science, and Cofounder, CanChild Centre for Childhood Disability Research, McMaster University, IAHS Building, Hamilton, ON
| | - Linsey Howie
- Linsey Howie, PhD, is Associate Professor, Department of Occupational Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Julie F. Pallant
- Julie F. Pallant, PhD, is Associate Professor and Director of Research and Graduate Studies, Rural Health Academic Centre, University of Melbourne, Shepparton, Victoria, Australia
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Alviar MJ, Olver J, Pallant JF, Brand C, de Steiger R, Pirpiris M, Bucknill A, Khan F. Can the ICF osteoarthritis core set represent a future clinical tool in measuring functioning in persons with osteoarthritis undergoing hip and knee joint replacement? J Rehabil Med 2012; 44:955-61. [PMID: 22948262 DOI: 10.2340/16501977-1041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
OBJECTIVE The High-level Mobility Assessment Tool (HiMAT) was developed to measure high-level mobility limitations following traumatic brain injury. The aim of this study was to investigate if the revised HiMAT is valid for use with adults with neurological conditions other than traumatic brain injury. DESIGN Cross-sectional study. SUBJECTS Ninety-five participants with neurological conditions. METHODS HiMAT score sheets were retrieved from the central medical files of people who had attended a major rehabilitation facility for a neurological condition from January 2006 to October 2007. Additional HiMAT score sheets were submitted by therapists who participated in the HiMAT User's Group. Rasch analysis (RUMM2030 software) was used to determine the overall fit of the model, individual item fit and differential item functioning. RESULTS Rasch analysis supported the internal validity of the revised eight-item HiMAT for individuals with neurological conditions. It showed good overall fit (P = 0.74), no misfitting items and excellent internal consistency (Person Separation Index = 0.91). The HiMAT is unidimensional with no evidence of response dependency and no differential item functioning for age or sex. CONCLUSION Further development of the revised HiMAT is required to investigate other aspects of validity, reliability and responsiveness in different neurological populations. However, the results support the internal validity of the revised HiMAT when used for people with neurological conditions who are able to walk without gait aids.
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Unsworth CA, Baker A, Taitz C, Chan SP, Pallant JF, Russell KJ, Odell M. Development of a standardised Occupational Therapy--Driver Off-Road Assessment Battery to assess older and/or functionally impaired drivers. Aust Occup Ther J 2011; 59:23-36. [PMID: 22272880 DOI: 10.1111/j.1440-1630.2011.00979.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Research has been conducted over several years to develop a new off-road assessment battery referred to as the Occupational Therapy - Driver Off-Road Assessment Battery. This article documents the development of the Battery, and provides preliminary research evidence to support its content and predictive validity. METHODS Literature reviews and a focus group with nine driver assessor occupational therapists were undertaken, as well as data collection using the Occupational Therapy - Driver Off-Road Assessment Battery with 246 clients. A Classification and Regression Tree model was constructed to ascertain the predictive validity of the Battery, with fitness-to-drive as the outcome. RESULTS Twenty-one physical, 13 sensory and seven assessments of cognition/perception were identified as being reflective of the skills required for driving. Following rating of their psychometric properties, the best assessments were presented to focus group members. The driver assessors supported the inclusion of several assessments and encouraged the development of new assessments. A draft version of the Occupational Therapy - Driver Off-Road Assessment Battery was tested and found to have excellent predictive validity for client on-road performance of 82.6%. The Classification and Regression Tree model showed that client performance on tests included in the Battery should be used together, rather than in isolation, to support fitness-to-drive recommendations. CONCLUSION This research identified the most suitable physical, sensory and cognitive assessments to include in the Occupational Therapy - Driver Off-Road Assessment Battery, and provided support for its validity. The development of this standardised battery assists driver assessors to accurately and consistently assess and report the off-road driving capacity of clients.
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Affiliation(s)
- Carolyn A Unsworth
- Department of Occupational Therapy, La Trobe University, Melbourne, Australia.
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Haines H, Rubertsson C, Pallant JF, Hildingsson I. Womens' attitudes and beliefs of childbirth and association with birth preference: a comparison of a Swedish and an Australian sample in mid-pregnancy. Midwifery 2011; 28:e850-6. [PMID: 22098781 DOI: 10.1016/j.midw.2011.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2011] [Revised: 09/11/2011] [Accepted: 09/24/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND the rate of caesarean in Australia is twice that of Sweden. Little is known about women's attitudes towards birth in countries where the caesarean rate is high compared to those where normal birth is a more common event. OBJECTIVES to compare attitudes and beliefs towards birth in a sample of Australian and Swedish women in mid-pregnancy. PARTICIPANTS women from rural towns in mid Sweden (n=386) and north-eastern Victoria in Australia (n=123). METHODS questionnaire data was collected from 2007 to 2009. Levels of agreement or disagreement were indicated on sixteen attitude and belief statements regarding birth. Principal components analysis (PCA) identified the presence of subscales within the attitudes inventory. Using these subscales, attitudes associated with preferred mode of birth were determined. Odds ratios were calculated at 95% CI by country of care. RESULTS the Australian sample was less likely than the Swedish sample to agree that they would like a birth that: 'is as pain free as possible' OR 0.4 (95% CI: 0.2-0.7), 'will reduce my chance of stress incontinence' OR 0.2 (95% CI: 0.1-0.8), 'will least affect my future sex life' OR 0.3 (95% CI: 0.2-0.6), 'will allow me to plan the date when my baby is born' OR 0.4 (95% CI: 0.2-0.7) and 'is as natural as possible' OR 0.4 (95% CI: 0.2-0.9). They were also less likely to agree that: 'if a woman wants to have a caesarean she should be able to have one under any circumstances' OR 0.4 (95% CI: 0.2-0.7) and 'giving birth is a natural process that should not be interfered with unless necessary' OR 0.3 (95% CI: 0.1-0.7). Four attitudinal subscales were found: 'Personal Impact of Birth', 'Birth as Natural Event', 'Freedom of Choice' and 'Safety Concerns'. Women who preferred a caesarean, compared to those who preferred a vaginal birth, across both countries were less likely to think of 'Birth as a natural event'. KEY CONCLUSIONS the Australian women were less likely than the Swedish women to hold attitudes and beliefs regarding the impact of pregnancy and birth on their body, the right to determine the type of birth they want and to value the natural process of birth. Women from both countries who preferred caesarean were less likely to agree with attitudes related to birth as a natural event.
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Affiliation(s)
- Helen Haines
- Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala Universitet, 751 85 Uppsala, Sweden.
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Khan F, Pallant JF, Amatya B, Ng L, Gorelik A, Brand C. Outcomes of high- and low-intensity rehabilitation programme for persons in chronic phase after Guillain-Barré syndrome: a randomized controlled trial. J Rehabil Med 2011; 43:638-46. [PMID: 21667009 DOI: 10.2340/16501977-0826] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the effectiveness of a high- vs low--intensity multidisciplinary ambulatory rehabilitation programme over 12 months for persons in the chronic phase after Guillain-Barré syndrome (pwGBS) in an Australian community cohort. METHOD A total of 79 pwGBS, recruited from a tertiary hospital, were randomized to a treatment group (n = 40) for an individualized high-intensity programme, or a control group (n = 39) for a lower intensity programme. The primary outcome the Functional Independence Measure (FIM) motor subscale assessed "activity limitation"; while secondary measures for "participation" included: World Health Organization Quality of Life; Depression, Anxiety Stress Scale; and Perceived Impact Problem Profile (PIPP) scales. All outcome measures were assessed at baseline and at 12 months. RESULTS Intention to treat analysis of data from 69 participants (treatment n = 35, control n = 34) showed reduced disability in the treatment group in post-treatment FIM domains (mobility, transfers, sphincter control and locomotion; all p < 0.005) and PIPP scores (relationships; p = 0.011), with moderate-to-small effect sizes (r = 0.36-0.23). The treatment group compared with control group showed significant improvement in function (FIM scores): 68% vs 32%. CONCLUSION Higher intensity rehabilitation compared with less intense intervention reduces disability in pwGBS in later stages of recovery. Further information on rehabilitation modalities and impact on quality of life is needed.
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Affiliation(s)
- Fary Khan
- Department of Medicine, Dentistry and Health sciences, The University of Melbourne, Royal Melbourne Hospital, Poplar Road, Parkville, Melbourne, VIC-3052, Australia.
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Unsworth CA, Pallant JF, Russell K, Odell M, Coulson M. Interrater Reliability of the Road Law and Road Craft Test as Part of the OT-DORA Battery for Off-Road Driver Assessment. Br J Occup Ther 2011. [DOI: 10.4276/030802211x13125646370960] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: The Occupational Therapy Driver Off Road Assessment (OT-DORA) Battery is in development as a comprehensive off-road evaluation of fitness to drive. Although several psychometric properties of the Road Law and Road Craft Test (RLRCT) have been previously studied, interrater reliability must also be established to include this test in the battery. Aim: The aim of the study was to determine the interrater reliability of the RLRCT. Method: Three occupational therapy driver assessors independently scored 20 client responses on the 14-item RLRCT. Results: The interrater reliability for all items, except item 6, was found to be between 0.57 and 1.00. The scoring instructions for item 6 were revised and the interrater reliability rose from 0.42 to 0.77. Conclusion: The RLRCT has been found to be reliable when administered by different raters and is thus suitable for inclusion in the OT-DORA Battery. Ongoing research to confirm the psychometric properties of the RLRCT is required.
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Affiliation(s)
- Carolyn A Unsworth
- Associate Professor, Department of Occupational Therapy, La Trobe University, Bundoora, Victoria, Australia; Adjunct Professor, School of Health Sciences, Jönköping University, Jönköping, Sweden; and Visiting Professor, Faculty of Health and Social Care, London South Bank University, London, UK
| | - Julie F Pallant
- Associate Professor, Rural Health Academic Centre, University of Melbourne, Shepparton, Victoria, Australia
| | - Kay Russell
- Senior Occupational Therapist, Austin Health Heidelberg Repatriation Hospital, Melbourne, Victoria, Australia
| | - Morris Odell
- Medical Adviser toVicRoads, Victorian Institute of Forensic Medicine, Monash University, Melbourne, Victoria, Australia
| | - Melissa Coulson
- Research Assistant, Department of Occupational Therapy, La Trobe University, Bundoora, Victoria, Australia
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Khan F, Pallant JF. Use of the International Classification of Functioning, Disability and Health to identify preliminary comprehensive and brief core sets for Guillain Barre syndrome. Disabil Rehabil 2010; 33:1306-13. [PMID: 21034203 DOI: 10.3109/09638288.2010.527031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To identify the preliminary comprehensive and brief core sets for Guillain Barre syndrome (GBS), in a Delphi process using the International Classification of Functioning, Disability and Health (ICF). METHOD Focus groups and a consensus process were used to identify ICF core sets for GBS. This included: preliminary ICF studies; empirical patient data collection for 77 GBS participants; review of the evidence base and treatment in GBS literature followed by a Delphi exercise with 23 physicians and allied health professionals in Melbourne, Australia. RESULTS The expert consensus selected 99 second level ICF categories (in three rounds) which identify health domains relevant to GBS for multidisciplinary assessment. These domains were consistent with current practice and existing GBS literature. The comprehensive core set includes: 27 (23%) categories from the component 'body function', 7 (12%) categories from 'body structures', 43 (36%) from 'activities and participation' and 22 (29%) from the component 'environmental' factors. The brief set comprised 20 categories, 20% of categories in the comprehensive core set. CONCLUSION The core set categories for GBS-related health need to be addressed in multidisciplinary care programs. Future clinical 'rating' of this set may facilitate scale development using the ICF in GBS. Further research is needed to confirm the generalisability of this set in clinical settings.
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Affiliation(s)
- Fary Khan
- Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC 3052, Australia.
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Swan WE, Liaw ST, Dunning T, Pallant JF, Kilmartin G. Diabetes risk reduction behaviours of rural postpartum women with a recent history of gestational diabetes. Rural Remote Health 2010; 10:1461. [PMID: 21090907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
INTRODUCTION For most women, gestational diabetes is temporary; however, an episode of gestational diabetes mellitus (GDM) confers an approximately seven-fold increased risk of developing type 2 diabetes mellitus. OBJECTIVE To examine readiness to adopt diabetes risk reduction behaviours and the prevalence of these behaviours among rural women with GDM during their last pregnancy. METHODS The study design was a self-administered mailed questionnaire seeking information about demographics, stage of change, physical activity level and dietary fat intake. SETTING Regional outpatient context. PARTICIPANTS Women with a single episode of GDM between 1 July 2001 and 31 December 2005 (n = 210). MAIN OUTCOME MEASURES Stage of change for physical activity, weight loss and reducing dietary fat behaviour; meeting activity targets, body mass index (BMI) and dietary fat score. RESULTS Eighty-four women returned completed questionnaires (40% response rate). Of the 77 women eligible (mean age 35 ± 3.8 years), 58% met recommended activity targets. Sixty-three percent of women were overweight or obese: mean BMI 29.6 kg/m² (± 7.30). Women reported a high level of preparedness to engage in physical activity, weight loss and reduction of fat intake. Thirty-nine percent of women had not had any postpartum follow-up glucose screening. Women who remembered receiving diabetes prevention information were significantly more likely to meet physical activity targets (p<0.05). CONCLUSIONS Readiness to engage in behaviour change was high among this group of rural women for all three diabetes risk reduction behaviours measured. However, despite a high proportion of women meeting activity targets and reducing fat intake, the majority of women remained overweight or obese. Postpartum follow-up glucose testing needs to be improved and the impact of diabetes prevention information provided during pregnancy warrants further study.
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Affiliation(s)
- W E Swan
- Diabetes Centre, Goulburn Valley Health, Shepparton, Victoria, Australia.
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Khan F, Pallant JF, Pallant JI, Brand C, Kilpatrick TJ. A randomised controlled trial: outcomes of bladder rehabilitation in persons with multiple sclerosis. J Neurol Neurosurg Psychiatry 2010; 81:1033-8. [PMID: 20542931 DOI: 10.1136/jnnp.2010.206623] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE A stratified, randomised, waitlist controlled study over 12 months assessed the effectiveness of a 6 week bladder rehabilitation programme in persons with multiple sclerosis (pwMS) in an Australian community cohort. METHODS Patients with definite MS and bladder issues (n=74) recruited from a tertiary hospital database were randomised to a treatment group (n=40) for an individualised bladder rehabilitation programme or to a control waitlist group (n=34). The Urogenital Distress Inventory (UDI6), Neurological Disability Scale (NDS) and the American Urological Association Symptom Index (AUA) assessed bladder impairment and 'activity limitation'; a single Quality of life (QoL) item in the AUA and the Incontinence Impact Questionnaire (IIQ7) measured restriction in 'participation'. Primary outcome measures were assessed at baseline and at 12 months. RESULTS Analysis of per protocol data from 58 patients (treatment n=24, control n=34) showed reduced disability in the treatment group, with significant differences (p<0.001) and large effect sizes (>0.5) in post-treatment UDI6, NDS, AUA total, AUA QoL and IIQ7 scores for the two groups. The treatment group compared with the control group showed improvement: 78% versus 27% for UDI6 and 59% versus 17% improved for IIQ7. More patients in the control group deteriorated over the study period on the UDI6 (30% vs 0%; p<0.001) and IIQ7 (39 vs 0%; p=0.001). CONCLUSION A multifaceted, individualised bladder rehabilitation programme reduces disability and improves QoL in pwMS compared with no intervention after 12 months of follow-up. Information on specific interventions in different bladder types in MS and the impact on QoL need further evaluation. Australian Clinical trials Registry ACTRNO12605000676617.
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Affiliation(s)
- F Khan
- Department of Medicine, Dentistry and Health Sciences, University of Melbourne and Royal Melbourne Hospital, Parkville, Melbourne, VIC 3052, Australia.
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Abstract
BACKGROUND The 21-item Modified Fatigue Impact Scale (MFIS) has been recommended as an outcome measure for use in multiple sclerosis and is commonly used to generate an overall score of fatigue. OBJECTIVE To test if the MFIS total score is valid by application of the Rasch measurement model. METHOD The MFIS was sent by post to patients with clinically definite multiple sclerosis in two centres in the UK. Data were fitted to the Rasch model. RESULTS Analysis was based on 415 records (55% response). The 21-item scale did not fit the Rasch model mainly because of multidimensionality. The scale was found to contain a "physical" dimension and a "cognitive" dimension, consistent with the original subscale structure. Valid physical and cognitive subscales were derived after deletion of some items. CONCLUSION The MFIS cannot be used to generate a single overall score of fatigue. The conceptual interaction between the two dimensions remains unclear, which poses problems when interpreting change scores in these individual scales. Studies in which a global MFIS score was used as either an outcome measure or selection tool may need to be re-evaluated.
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Affiliation(s)
- R J Mills
- Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool, UK.
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Lambert S, Pallant JF, Girgis A. Rasch analysis of the Hospital Anxiety and Depression Scale among caregivers of cancer survivors: implications for its use in psycho-oncology. Psychooncology 2010; 20:919-25. [PMID: 20669337 DOI: 10.1002/pon.1803] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Revised: 05/03/2010] [Accepted: 06/08/2010] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The Hospital Anxiety and Depression Scale (HADS) is often used to screen for cancer caregivers' anxiety and depression, despite few studies examining the tool's psychometric performance within this population. The purpose of this article is to use Rasch analysis to assess the psychometric properties of the HADS in a sample of cancer caregivers. METHODS HADS was administered to 541 caregivers of a population-based sample of patients diagnosed with one of the eight most incident cancers in Australia. Rasch analysis was conducted using RUMM2020. RESULTS More than two-thirds of caregivers were women and most participants were married (95.9%) and caring for their spouse/partner with cancer (89.8%). The HADS-Anxiety (HADS-A) subscale showed good fit to the model, with appropriate internal consistency after removal of item 11. There were no disordered thresholds and no differential item functioning (DIF) for sex or age. To achieve satisfactory model fit for the HADS-Depression (HADS-D) subscale item 8 was removed due to DIF for sex and item 14 was rescored to resolve disordered thresholds. Analyses supported the unidimensionality of the individual subscales; however, there was no support for the combination of subscales to form a HADS-Total. CONCLUSIONS The results of Rasch analysis support the use of a modified version of the HADS-A and HADS-D among cancer caregivers. Further research is needed to confirm these findings and identify revised clinical cut-points. Findings reinforce the need for clinicians and researchers to formally test the psychometric properties of the instruments that they intend to use with different samples. Copyright © 2010 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sylvie Lambert
- Centre for Health Research and Psycho-oncology (CHeRP), Cancer Council NSW, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
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Krahe LM, McColl AR, Pallant JF, Cunningham CE, Dewitt DE. A multi-university study of which factors medical students consider when deciding to attend a rural clinical school in Australia. Rural Remote Health 2010; 10:1477. [PMID: 20828219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION As in many developed nations, there is a shortage in the rural medical workforce in Australia. Research indicates that a strong relationship exists between rural educational exposure and an increased interest in pursuing a rural career or selecting a rural internship. Accordingly, in 2000 the Australian Commonwealth Government established the Rural Clinical Schools (RCS) program. Under this program, 25% of parent medical schools' Commonwealth Supported Place (CSP) medical students must spend at least 1 year of their clinical medical education in a rural setting. Research indicates that positive experiences are of vital importance in determining future rural practice. Arguably, if students are conscripted to a RCS, they may view their overall experience negatively. Thus, the development and sustainability of an adequate future rural medical workforce depends on medical schools understanding and fostering the factors that encourage voluntary student recruitment to the RCSs. The aim of the present study was to determine which factors Australian medical students consider in their decision to attend RCSs. METHODS This study employed survey research. The questionnaire, which used a 6 point Likert scale, addressed factors influencing students' decision to attend an RCS, including whether these factors were viewed as positive or negative. Open-ended questions provided students with an opportunity to make comments about their decision-making. The setting was the RCSs of six participating Australian universities. The participants were medical students enrolled at one of six Australian universities in 2006 (n=166) who had completed their RCS term; 125 students responded (75% response rate). RESULTS At least three-quarters of the respondents considered the following when deciding whether to attend an RCS: patient access, academic reputation, their friends, the availability of subsidized accommodation provided by the clinical school, extra-curricular activities, social opportunities and transport costs. The majority of students considered the following as positive considerations: 'patient access', 'academic reputation', and 'subsidized accommodation'. However, for other students these same factors were negative considerations. CONCLUSION Students consider both clinical and non-clinical factors in their decision to attend an RCS. The primary positive factor in the present study was patient access with 97% students (n=119) considering this to be important, and 84% students (n=81) stating that this was a positive factor in their decision-making. The other major factors, friends and academic reputation, appear equally considered. However, they differed in the degree to which they were regarded as a positive or negative consideration. Identifying and promoting positive factors is essential if the future rural medical workforce is to be enhanced. This study supports the importance of RCSs not being over-crowded and, thus, maintaining patient access, and also the importance of institutions having sufficient resources to support an excellent academic reputation. Interestingly, and perhaps somewhat contrary to expectations, students of metropolitan origin appear to be increasingly attracted to RCSs. Although numerous studies show that rural origin is a strong predictor of rural medical workforce membership, urban students who attend an RCS and have a positive experience may also be open to future rural practice.
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Affiliation(s)
- Lee M Krahe
- The University of New South Wales, Rural Clinical School, New South Wales, Australia.
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Bourke-Taylor H, Law M, Howie L, Pallant JF. Development of the Child's Challenging Behaviour Scale (CCBS) for mothers of school-aged children with disabilities. Child Care Health Dev 2010; 36:491-8. [PMID: 20047597 DOI: 10.1111/j.1365-2214.2009.01055.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Caring for a child with a disability can be especially difficult when the child exhibits challenging behaviours. Childhood disability often calls for the mother to be conscientious, capable and organized to meet the child's health and developmental needs. Mothers are known to feel particularly stressed when their child also behaves in ways that are difficult to manage. In these circumstances maternal mental health may be compromised and mothers therefore need more support. The Child's Challenging Behaviour Scale (CCBS) is an 11-item scale that measures a mother's report of challenging behaviours exhibited by their child with disability, that are associated with compromised maternal mental health and caregiving difficulties. This paper describes the initial development and psychometric evaluation of the CCBS. METHODS A mixed methodology instrument design model was used to develop the CCBS. A qualitative study generated items, and quantitative data were collected from 152 mothers of a child with a disability. RESULTS The CCBS showed excellent internal consistency (Cronbach's alpha = 0.89) and factor analysis supported its unidimensionality. Construct validity was supported by correlations with the PedsQL Psychosocial Health Summary Score (rho =-0.51) and cooperation taking medication (rho = 0.40). There were significant differences in CCBS scores between groups of children with and without either autism or psychiatric conditions. The CCBS showed moderate correlations with self-reported health status; the mother's sense of empowerment (rho =-0.44); and family cohesion (rho =-0.30). Mothers with a mental health condition recorded significantly higher CCBS scores. CONCLUSIONS The CCBS is a brief, psychometrically sound instrument that provides clinicians with a new tool that measures a mother's rating of their child's behaviours that are challenging and associated with reduced maternal well-being. The CCBS assists professionals to identify mothers and family situations who may be in need of more support and interventions.
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Affiliation(s)
- H Bourke-Taylor
- School of Occupational Therapy, La Trobe University, Bundoora, Vic., Australia.
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Unsworth CA, Pallant JF, Russell KJ, Germano C, Odell M. Validation of a Test of Road Law and Road Craft Knowledge With Older or Functionally Impaired Drivers. Am J Occup Ther 2010; 64:306-15. [DOI: 10.5014/ajot.64.2.306] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. The number of functionally impaired drivers being assessed is increasing the urgency to develop a standardized off-road driver assessment battery. We examined the validity of the Road Law and Road Craft Test (RLRCT) and a version of the Melbourne Slide Test to determine whether they should be included in the Occupational Therapy Driver Off-Road Assessment (OT–DORA) battery, which is under development.
METHOD. We conducted a file audit of 118 data sets with individual item scores for the RLRCT and Melbourne Slide Test.
RESULTS. The RLRCT test with one item removed provides clinicians with a valid indication of clients’ off-road driving skills. The Melbourne Slide Test added no new information over that provided by the RLRCT and can be excluded from the battery.
CONCLUSION. The revised 14-item RLRCT should be included in the OT–DORA battery. Further research is required to develop the OT–DORA battery as a valid and reliable measure of off-road driver skill.
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Affiliation(s)
- Carolyn A. Unsworth
- Carolyn A. Unsworth, PhD, OTR, AccOT, is Associate Professor, School of Occupational Therapy, La Trobe University, Melbourne, Victoria 3086 Australia; ; Adjunct Professor, School of Health Sciences, Jönköping University, Jönköping, Sweden; and Visiting Professor, Faculty of Health and Social Care, London South Bank University, London, England
| | - Julie F. Pallant
- Julie F. Pallant, PhD, is Associate Professor, School of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
| | - Kay J. Russell
- Kay J. Russell, AccOT, OTR, is Senior Occupational Therapist, Occupational Therapy, Austin Health Heidelberg Repatriation Hospital, Melbourne, Victoria, Australia
| | - Carmela Germano
- Carmela Germano, MBSc, is Research Associate, School of Occupational Therapy, La Trobe University, Melbourne, Victoria, Australia
| | - Morris Odell
- Morris Odell, MBBS, FRACGP, DMJ, FFFLM, is Medical Advisor to VicRoads, Victorian Institute of Forensic Medicine, Monash University, Melbourne, Victoria, Australia
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Mills RJ, Young CA, Pallant JF, Tennant A. Development of a patient reported outcome scale for fatigue in multiple sclerosis: The Neurological Fatigue Index (NFI-MS). Health Qual Life Outcomes 2010; 8:22. [PMID: 20152031 PMCID: PMC2834659 DOI: 10.1186/1477-7525-8-22] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 02/12/2010] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Fatigue is a common and debilitating symptom in multiple sclerosis (MS). Best-practice guidelines suggest that health services should repeatedly assess fatigue in persons with MS. Several fatigue scales are available but concern has been expressed about their validity. The objective of this study was to examine the reliability and validity of a new scale for MS fatigue, the Neurological Fatigue Index (NFI-MS). METHODS Qualitative analysis of 40 MS patient interviews had previously contributed to a coherent definition of fatigue, and a potential 52 item set representing the salient themes. A draft questionnaire was mailed out to 1223 people with MS, and the resulting data subjected to both factor and Rasch analysis. RESULTS Data from 635 (51.9% response) respondents were split randomly into an 'evaluation' and 'validation' sample. Exploratory factor analysis identified four potential subscales: 'physical', 'cognitive', 'relief by diurnal sleep or rest' and 'abnormal nocturnal sleep and sleepiness'. Rasch analysis led to further item reduction and the generation of a Summary scale comprising items from the Physical and Cognitive subscales. The scales were shown to fit Rasch model expectations, across both the evaluation and validation samples. CONCLUSION A simple 10-item Summary scale, together with scales measuring the physical and cognitive components of fatigue, were validated for MS fatigue.
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Affiliation(s)
- Roger J Mills
- The Walton Centre for Neurology and Neurosurgery, Liverpool, L9 7LJ, UK.
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McLaughlin EGH, Adamson BJ, Lincoln MA, Pallant JF, Cooper CL. Turnover and intent to leave among speech pathologists. AUST HEALTH REV 2010; 34:227-33. [DOI: 10.1071/ah08659] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Accepted: 06/15/2009] [Indexed: 11/23/2022]
Abstract
Sound, large scale and systematic research into why health professionals want to leave their jobs is needed. This study used psychometrically-sound tools and logistic regression analyses to determine why Australian speech pathologists were intending to leave their jobs or the profession. Based on data from 620 questionnaires, several variables were found to be significantly related to intent to leave. The speech pathologists intending to look for a new job were more likely to be under 34 years of age, and perceive low levels of job security and benefits of the profession. Those intending to leave the profession were more likely to spend greater than half their time at work on administrative duties, have a higher negative affect score, not have children under 18 years of age, and perceive that speech pathology did not offer benefits that met their professional needs. The findings of this study provide the first evidence regarding the reasons for turnover and attrition in the Australian speech pathology workforce, and can inform the development of strategies to retain a skilled and experienced allied health workforce.
What is known about the topic?There is a recognised shortage of speech pathologists in Australia, and a growing need for their services. Despite this, there has been no large scale systematic investigation to clarify the reasons why Australian speech pathologists may be leaving their jobs or the profession.
What does this paper add?This is the first large scale nationwide investigation into why Australian speech-language pathologists leave their jobs or the profession. Approximately 31% of Australian speech pathologists intended to change jobs and 13% intended to change professions in search of opportunities for promotion, better pay and more rewarding and interesting work. The traditional assumption that speech pathologists have been leaving the profession due to family responsibilities was not supported, as it appeared that speech pathologists without young children were more likely to explore roles outside the profession.
What are the implications for practitioners?One way to address the issues raised in this study is for practising speech pathologists to increase their participation in industrial, organisational, educational and professional activities such as negotiating working conditions and lobbying. Student supervision, mentoring and professional supervision are important avenues for developing resilience and such skills that have not traditionally been given priority in the education of health professionals.
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Khan F, Pallant JF, Shea TL, Whishaw M. Multiple sclerosis: prevalence and factors impacting bladder and bowel function in an Australian community cohort. Disabil Rehabil 2009; 31:1567-76. [DOI: 10.1080/09638280802639566] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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