Measuring Adolescent Attitudes Towards Abortion

Background Measurement scales seeking to quantify latent traits like attitudes, are often developed using traditional psychometric approaches. Application of the Rasch unidimensional measurement model may complement or replace these techniques, as the model can be used to construct scales and check their psychometric properties. If data fit the model, then a scale with invariant measurement properties, including interval-level scores, will have been developed. Aims This paper highlights the unique properties of the Rasch model. Items developed to measure adolescent attitudes towards abortion are used to exemplify the process. MethodTen attitude and intention items relating to abortion were answered by 406 adolescents aged 12 to 19 years, as part of the “Teen Relationships Study”. The sampling framework captured a range of sexual and pregnancy experiences. Items were assessed for fit to the Rasch model including checks for Differential Item Functioning (DIF) by gender, sexual experience or pregnancy experience. ResultsRasch analysis of the original dataset initially demonstrated that some items did not fit the model. Rescoring of one item (B5) and removal of another (L31) resulted in fit, as shown by a non-significant item-trait interaction total chi-square and a mean log residual fit statistic for items of -0.05 (SD=1.43). No DIF existed for the revised scale. However, items did not distinguish as well amongst persons with the most intense attitudes as they did for other persons. A person separation index of 0.82 indicated good reliability. ConclusionApplication of the Rasch model produced a valid and reliable scale measuring adolescent attitudes towards abortion, with stable measurement properties. The Rasch process provided an extensive range of diagnostic information concerning item and person fit, enabling changes to be made to scale items. This example shows the value of the Rasch model in developing scales for both social science and health disciplines

Developing a Self-Administered Questionnaire as a Guide to Consultations with Women Treated for Breast Cancer

Background. Health professionals, including general practitioners involved in followup of breast cancer patients, need to systematically assess opportunities to offer patients support with ongoing or new problems. Methods. A self-administered needs assessment questionnaire was developed with reference to a multidisciplinary team. Short, evidence-based, readable questions were emphasized, and questions were tested for face validity. The questions flowed across three domains: physical, social, and psychological. Content validity and user friendliness were assessed. Results. A final set of 30 questions was rated as easy to read and comprehend (Flesch Reading Ease score 65.8 and Flesch-Kincaid Grade Level 6.9). When piloted with twenty-one patients the self-administered questionnaire detected 121 items of unmet need encompassing all three domains. Conclusions. This self-administered questionnaire has the potential to assist in the holistic assessment of breast cancer patient after treatment. The clinical value of the self-administered questionnaire will need to be further tested before it can be widely adopted

Services and attitudes to people living with HIV/AIDS among college students in Dar-es-Salaam, Tanzania

OBJECTIVES: The objective of this study was to evaluate acceptability of voluntary testing, counselling and treatment services and attitudes towards people living with HIV/AIDS from young people's point of view. METHODS: Qualitative study (face-to-face interviews in which tapes were used) were carried out in 20 interviewed college students aged between 19-24 years of both sexes based in Dar-es-Salaam, Tanzania.RESULTS: Results showed that voluntary counselling and testing services were limited in the study area at the time of study. Participants complained of unfriendly services and unco-operative staff, poor counselling services and shortage of facilities and staff. There was fear of HIV/AIDS related stigma toward people living with HIV and AIDS, thus fostering stigma and isolation against them. Results further demonstrate that HIV/AIDS related stigma is still a very serious problem in Tanzania. Lack of HIV/AIDS related knowledge and the life-threatening character of the disease were seen as the most important determinants of AIDS-related stigma. The main benefit to go for VCT was 'knowing your status before marriage', whereas main barriers for testing were 'fear of being stigmatised' and 'fear of knowing your HIV positive status'. CONCLUSION: The results suggest that there is need of VCT specific intervention programs for young people in colleges in Tanzania to emphasize of importance of VCT services and HIV/AIDS education program to educate students' understanding of people living with HIV/AIDS, thus reducing stigma towards people living with HIV/AIDS

Attitudes and beliefs about HIV/AIDS behaviour and education among Tanzanian youth

Background: Tanzania faced with an increasing problem from HIV sexual infection and vulnerability of students is a key concern. This paper explores beliefs, attitudes and behavioural perspectives on HIV/AIDS education among students in Tanzania as there has been few qualitative information on the subject. Methods: A total of 20 college students of both sexes were interviewed in a qualitative study. Health Belief Model and Social Cognitive Theory were used to guide the interview and constant comparative analysis on their attitudes, beliefs, behaviour and education towards HIV infection risks were utilised. Results: During the interview, the following topics emerged: misinformation and desire for HIV/AIDS education program in school curricula; perceptions of one’s own and peer’s susceptibility to HIV infection; social norms regarding sexual behaviour and perceptions regarding access to education and health services. Lack of accurate information and lack of education at home and at school further contributed to risk behaviour.Conclusion: The study highlighted important perspectives of students towards HIV infection, risk behaviours which are important for HIV prevention programs for students. Based on the findings, recommendations for improvement in prevention programs among college students within Tanzanian schools context are discussed

Testing the psychometric properties of Mandarin version of the fertility problem inventory (M-FPI) in an infertile Chinese sample

The Fertility Problem Inventory (FPI) is an instrument to measure infertility-related stress, and has been widely used in a range of clinical settings. It has been translated into several languages, however there is no validated Mandarin version. The present study tests the psychometric properties of the Mandarin version of FPI (M-FPI). A hospital sample of 223 infertile Chinese couples (223 men and 223 women) completed the M-FPI along with other measures including demographics, Hospital Anxiety and Depression Scale, and Marlowe-Crowne Social Desirability Scale, which were used to assess the reliability and validity of the Mandarin version of FPI. Results showed that the M-FPI was best reduced to a five-factor solution, and all 46 items of the M-FPI showed moderate to high internal consistency. In addition, the test of convergent and discriminant validity from this study indicated satisfactory results. These results indicate that the M-FPI as an instrument is reliable and valid for use with infertile Chinese couples in clinical assessment

Timely cancer diagnosis and management as a chronic condition: opportunities for primary care

One in three men and one in four women in Australia will be diagnosed with cancer in the first 75 years of life. The majority will survive the cancer and ultimately die from unrelated causes. Many cancer patients and their families will experience some physical, social, economic and psychological sequelae, regardless of the prognosis. A recurring theme is that patients are disadvantaged by the lack of coordination of care and their needs are not being adequately met. We argue that greater integration of care through a multidisciplinary team of professionals, peer support groups and primary health practitioners functioning within a care hub could offer better practical and psychosocial supportive care for patients and their families

Sex, Condoms and Sexually Transmissible Infections: A Qualitative Study of Sexual Health in Young Australian Men

Young males have a key role in shaping contraceptive use in a sexual relationship, yet often remain the invisible partner in safe sex promotion. This article describes a conceptual model of STI risk and condom use based on the perceptions and experiences of condom use in a group of young Australian males. An explorative descriptive design was used to conceptualize participants’ condom use histories into an organized description of behavior. Forty-two semi-structured interviews were conducted with a purposive sample of males aged 15 to 25 years over an 18 month period. A sequential analytical process of data immersion, coding, and category generation was used to identify personal meanings, motivations, and contextual factors associated with condom use and non-use. Three primary discourses associated with young males’ perceptions of STI risk and responding approach to condom use constructed personal commitment to sexual safety as dynamic, context-dependent, and outcome-driven (pregnancy versus STIs as the primary motivator of condom use). A regretful discourse associated with experiences of, or suspected unwanted outcomes, also emerged through changes in risk appraisals and safe sex intentions and behavior. Interventions to increase condom use should go beyond the traditional focus on risky behavior and disease prevention frameworks by addressing the contextual influences on personal risk appraisals and deliver innovative messages to reduce negative social meanings associated with condom use