A Comparison of Quality of Life Measures in Husbands of Women with Breast Cancer

The Quality of Well-Being Scale (QWB-SA) and Medical Outcome Study SF-36 short form (SF-36) are popular health-related quality of life (HRQOL) assessment tools; however, it is unclear whether these measures overlap enough to be interchangeable, and if not, which might be a better choice. This study examined conceptual overlap, validity, and relation with psychosocial functioning of the QWB-SA and SF-36 in a sample of partners of women undergoing adjuvant treatment for breast cancer. Partners (n = 79) of breast cancer patients, recruited in a chemotherapy infusion clinic, completed the QWB-SA and SF-36 and additional psychosocial measures. Descriptive content review shows that both instruments provide a breadth of HRQOL coverage including physical health, mental health, social functioning, role functioning and general health perceptions; however, more QWB-SA scales suffered floor effects. Subscales correlated, with the strongest correlations between the QWB-SA total score and the mental health scales of the SF-36. The QWB-SA and the SF-36 Mental Health Component Summary score, but not the SF-36 Physical Component Summary score were strongly correlated to measures of mood, satisfaction with life, burden, and social support. The QWB-SA and SF-36 measure distinct aspects of HRQOL. Each instrument presents distinct advantages and disadvantages in coverage of particular domains. Labels assigned to SF-36 scales more accurately reflect what they measure. The SF-36 appeared more sensitive to the impact that psychological health played on overall assessment of HRQOL in these partners

Assessing safety climate in acute hospital settings: a systematic review of the adequacy of the psychometric properties of survey measurement tools

Background: The perceived importance of safety culture in improving patient safety and its impact on patient outcomes has led to a growing interest in the assessment of safety climate in healthcare organizations; however, the rigour with which safety climate tools were developed and psychometrically tested was shown to be variable. This paper aims to identify and review questionnaire studies designed to measure safety climate in acute hospital settings, in order to assess the adequacy of reported psychometric properties of identified tools. Methods: A systematic review of published empirical literature was undertaken to examine sample characteristics and instrument details including safety climate dimensions, origin and theoretical basis, and extent of psychometric evaluation (content validity, criterion validity, construct validity and internal reliability). Results: Five questionnaire tools, designed for general evaluation of safety climate in acute hospital settings, were included. Detailed inspection revealed ambiguity around concepts of safety culture and climate, safety climate dimensions and the methodological rigour associated with the design of these measures. Standard reporting of the psychometric properties of developed questionnaires was variable, although evidence of an improving trend in the quality of the reported psychometric properties of studies was noted. Evidence of the theoretical underpinnings of climate tools was limited, while a lack of clarity in the relationship between safety culture and patient outcome measures still exists. Conclusions: Evidence of the adequacy of the psychometric development of safety climate questionnaire tools is still limited. Research is necessary to resolve the controversies in the definitions and dimensions of safety culture and climate in healthcare and identify related inconsistencies. More importance should be given to the appropriate validation of safety climate questionnaires before extending their usage in healthcare contexts different from those in which they were originally developed. Mixed methods research to understand why psychometric assessment and measurement reporting practices can be inadequate and lacking in a theoretical basis is also necessary

Haematological malignancy: are we measuring what is important to patients? A systematic review of quality of life instruments

© 2018 The Authors. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.The wide range of health‐related quality‐of‐life (HRQoL) instruments used in haematology makes it challenging for haematologists and other care team members in practice to select, use and understand the scoring system and finally interpret the results. The main objectives of this study were to: (a) provide a comprehensive list of quality‐of‐life issues important to patients suffering from haematological malignancies, identified through the literature; (b) provide a list of health‐related quality‐of‐life (HRQoL) instruments used in haematological malignancies in both daily clinical practice and research; and (c) evaluate the relevance and comprehensibility of the identified instruments in haematological malignancies. Systematic literature review of two databases, followed by addition of articles by manual searching, was carried out. The articles focusing on the primary studies, which have used semi‐structured/structured interviews or surveys to identify issues important to HM patients, and other studies describing the results of testing measurement properties, such as reliability, validity and responsiveness of the instruments currently used to evaluate the HRQoL in different HMs, were included. Fifty‐seven studies reported development and validation of 30 HRQoL instruments, which have been used in haematology. Twenty‐four studies were identified using qualitative methods to report HRQoL issues and symptoms from a patient's perspective. No identified instrument captured all the issues identified from the qualitative studies. None of the instruments reviewed appeared to have been developed for use in clinical practice and specifically for patients with HM, except MyPOS. Furthermore, measurement properties were established, largely, in clinical trial scenarios. There is a need for development of a new HRQoL instrument entirely based on involvement of patients with haematological malignancies.Peer reviewe

Validation of the Adverse Childhood Experiences Questionnaire

Orientação: Ricardo José Martins PintoExperiências adversas na infância (ACE) são experiências que ocorrem na infância, tais como abuso, negligência e tipos de disfunção familiar, que aumentam o risco de problemas de saúde física e psicológica e afetam o desenvolvimento. As ACE são avaliadas normalmente através de uma entrevista semiestruturada. No entanto existem muitos instrumentos que completam o diagnóstico, como o Questionário das Experiências Adversas na Infância. Existem várias vantagens em analisar as propriedades psicométricas do instrumento e esta dissertação visa examinar a estrutura fatorial deste questionário. Método: Foram utilizados dados da versão portuguesa do Questionário ACE. A amostra incluiu 383 adolescentes. A média de idades foi de 17 anos (M = 16.52, SD = 1.74), variando entre 13 e 23 anos (171 (44.6%) do sexo masculino e 212 (55.4%) do sexo feminino). Resultados: Aproximadamente metade da amostra relatou exposição a três/ quatro ACE (n = 192; 50.1%). Considerando a análise fatorial confirmatória, os resultados mostraram que todos os modelos testados apresentaram baixos índices. Contudo, a análise da consistência interna revelou valores altos de alfa. Conclusão: Apesar do questionário ACE ser um dos instrumentos de autorrelato mais utilizados nesta área, a validade de construto requer mais estudos no sentido de se estreitar a relação entre o plano conceptual e o estatístico. Contudo, importa referir que ainda permanece em debate o melhor método para avaliar a validade de construtos que envolvem experiências, comparativamente a outros construtos. Consequentemente, os procedimentos tradicionais quando uma nova medida é desenvolvida, como confiabilidade interna e análise fatorial, podem não ser métodos apropriados para instrumentos que avaliam experiências de vida, e o nosso estudo parece corroborar essa hipótese. Alguns investigadores sugerem o teste-reteste como o melhor método, pelo que seria importante alargar o estudo e fazer esse tipo de análise.Adverse Childhood Experiences (ACEs) are traumatic events in childhood, like abuse, neglect and kinds of serious household dysfunction, that can increase risk for physical or psychological health and development. ACEs are mostly evaluated with a careful semi-structured interview. However, there are many instruments that complete the diagnosis, like the ACE Questionnaire. There are several advantages to examining the psychometric properties of the instrument, and this dissertation aims to access and examine the factorial structure of this questionnaire. Method: We used a data from the Portuguese version of the ACE Study Questionnaire. The sample included 383 adolescents. The mean of the age was 17 years old (M = 16.52, SD = 1.74), ranged between 13 and 23 years old (171 (44.6%) males and 212 (55.4%) females). Results: Approximately half of the sample reported having been exposed at three/four ACE (n = 192; 50.1%). Considering fit indices models, results presented that all tested models presented poor fit. However, the analysis of internal consistency showed high alpha values. Conclusion: Although the ACE questionnaire is one of the most commonly used self-report instruments to assess this theme, construct validity requires further studies in order to narrow the relationship between the conceptual and statistical planes. However, they should be aware that the best method for assessing the validity of constructs involving experiments as compared to other constructs is still under debate. Consequently, traditional procedures when a new measure is developed, such as internal reliability and factor analysis, may not be appropriate methods for instruments that evaluate life experiences, and our study seems to corroborate this hypothesis. Some researchers suggest that test-retest may be the best method, so it would be important to extend the study and do this kind of analysis in the future

Why do British Indian children have an apparent mental health advantage?

BACKGROUND: Previous studies document a mental health advantage in British Indian children, particularly for externalising problems. The causes of this advantage are unknown. METHODS: Subjects were 13,836 White children and 361 Indian children aged 5-16 years from the English subsample of the British Child and Adolescent Mental Health Surveys. The primary mental health outcome was the parent Strengths and Difficulties Questionnaire (SDQ). Mental health was also assessed using the teacher and child SDQs; diagnostic interviews with parents, teachers and children; and multi-informant clinician-rated diagnoses. Multiple child, family, school and area factors were examined as possible mediators or confounders in explaining observed ethnic differences. RESULTS: Indian children had a large advantage for externalising problems and disorders, and little or no difference for internalising problems and disorders. This was observed across all mental health outcomes, including teacher-reported and diagnostic interview measures. Detailed psychometric analyses provided no suggestion of information bias. The Indian advantage for externalising problems was partly mediated by Indian children being more likely to live in two-parent families and less likely to have academic difficulties. Yet after adjusting for these and all other covariates, the unexplained Indian advantage only reduced by about a quarter (from 1.08 to .71 parent SDQ points) and remained highly significant (p < .001). This Indian advantage was largely confined to families of low socio-economic position. CONCLUSION: The Indian mental health advantage is real and is specific to externalising problems. Family type and academic abilities mediate part of the advantage, but most is not explained by major risk factors. Likewise unexplained is the absence in Indian children of a socio-economic gradient in mental health. Further investigation of the Indian advantage may yield insights into novel ways to promote child mental health and child mental health equity in all ethnic groups

Instrument development, data collection, and characteristics of practices, staff, and measures in the Improving Quality of Care in Diabetes (iQuaD) Study

Peer reviewedPublisher PD

Psychological capital, wellbeing and patient safety attitudes of nurses and midwives: a cross-sectional survey.

Nursing and midwifery are unarguably stressful endeavours requiring high levels of psychological capital and coping strategies. The impact of the work environment on patient safety outcomes suggests that high nurse/midwife stress may be associated with more adverse patient events. The purpose of the study was to explore the psychological capital of clinical nurses and midwives and identify explanatory factors (including psychological capital, well-being and health related behaviours) contributing to attitudes to patient safety. A descriptive web and paper-based survey comprising a convenience sample of nurses and midwives in acute health facilities in Sydney, Australia was performed (October 2018 and April 2019). Variables included: psychological capital; psychological wellbeing; work culture and attitudes to patient safety. Descriptive statistics were performed and a regression model was specified (a statistical significance of p < 0.05 was set a priori). Psychological capital, depression score and work engagement had a significant effect on patient safety perceptions when controlling for other factors. The findings suggest that nurse and midwife wellbeing is an important consideration when striving to improve patient safety. This article is protected by copyright. All rights reserved

Collecting Data from Children Ages 9-13

Provides a summary of literature on common methods used to collect data, such as diaries, interviews, observational methods, and surveys. Analyzes age group-specific considerations, advantages, and drawbacks, with tips for improving data quality

Medical student confidence to care for a dying patient and their family: a systematic review

Background: The General Medical Council expects medical graduates to care for dying patients with skill, clinical judgement and compassion. UK surveys continually demonstrate low confidence and increasing distress amongst junior doctors when providing care to the dying. Aim: This systematic review aims to determine what has been evidenced within worldwide literature regarding medical undergraduate confidence to care for dying patients. Design: A systematic electronic search was undertaken. Data extraction included measurements of baseline confidence, associated assessment tools, and details of applied educational interventions. Pre/post-intervention confidence comparisons were made. Factors influencing confidence levels were explored. The review was prospectively registered via PROSPERO (CRD42019119057). Data sources: MEDLINE, CINAHL, EMBASE, ISI Web of Science, ERIC, PsychINFO, British Education Index and Cochrane Review databases were accessed, with no restrictions on publication year. Eligible studies included the terms ‘medical student’, ‘confidence’, and ‘dying’, alongside appropriate MeSH headings. Study quality was assessed using the Mixed Methods Appraisal Tool. Results: Fifteen eligible studies were included, demonstrating a diversity of assessment tools. Student confidence was low in provision of symptom management, family support, and psycho-spiritual support to dying patients. Eight interventional studies demonstrated increased post-interventional confidence. Lack of undergraduate exposure to dying patients and lack of structure within undergraduate palliative care curricula were cited as factors responsible for low confidence. Conclusion: This review clarifies the objective documentation of medical undergraduate confidence to care for the dying. Identifying where teaching fails to prepare graduates for realities in clinical practice will help inform future undergraduate palliative care curriculum planning