The relationship between self-efficacy and health-related quality of life in Multiple Sclerosis patients

Background and Objectives Multiple sclerosis (MS) has a broad spectrum of physical, social, psychological effects and significant impact on quality of life (QoL). Several studies has showed the importance of self-efficacy as a predictor of QoL in patients with MS.This study aims at evaluating the robustness of the relationship between self-efficacy and QoL. Specifically it aims to test whether such relation will vanish under the following conditions: using a general measure of self-efficacy and controlling for level of impairment defined as a broad construct dealing with physical, social and working changes due to the illness condition. Methods One hundred-fifty five participants responded to a questionnaire, including QoL and general self-efficacy measures, socio demographic and clinical variables. Two nested structural equation models that differ for the presence or absence of the path connecting self-efficacy and QoL was estimated.Results and Conclusions The hypothesis of the vanishing of the relationship between self-efficacy and QoL had to be rejected. These results support the genuineness of this relation and emphasize the importance of interventions promoting self-efficacy to improve QoL in chronic diseases such as MS. From a methodological perspective this study is an example of the usefulness of formative indicators in QoL studies

Improving the psychometric properties of the dissociative experiences scale (DES-II):A Rasch validation study

Background : The Dissociative Experiences Scale-II (DES-II) is a self-report questionnaire that measures dissociative experiences such as derealization, depersonalization, absorption and amnesia. The DES-II has been prevalently used as a screening tool in patients suffering from psychotic disorders or schizophrenia. However, dissociative experiences can also be part of normal psychological life. Despite its popularity, the most problematic aspect of the DES-II is the inconsistency in its factor structure, which is probably due to the tendency to treat ordinal responses as responses on an interval scale, as it is assumed in the Classical Test Theory approach. In order to address issues related to the inconsistency of previous results, the aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis, i.e. analyzing the functioning of the response scale. Methods: Data were obtained on a sample composed by 320 Italian participants (122 inmates and 198 community-dwelling individuals) and were analyzed with the Rasch model. This model allows the estimation of participants' level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement invariance. Moreover, Rasch estimation allows to determine the best response scale, in terms of response modalities number and their discriminant power. Results: Three items of the scale had strong misfit. After their deletion, the resulting scale was composed by 25 items, which had low levels of misfit and high reliability, and showed measurement invariance. Participants tended to select more often lower categories of the response scale. Conclusions: Results provided new knowledge on the DES-II structure and its psychometric properties, contributing to the understanding and measurement of the dissociation construct

Not All Academics Are Alike: First Validation of the Academics' Quality of Life at Work Scale (AQoLW)

Background: Relating to the macro-level changes and the increasing complexity of the academic system, a growing number of studies began to investigate the perceived working context impact on well-being and job satisfaction of academics. A unique duality characterizes this context: academics cannot be longer defined as stress-free, but at the same time they are still satisfied and engaged in their work. There is a need to evaluate the academic environment not only in terms of stressor and strain, but also in terms of which experiences are sources of fulfillment. The study aimed to explore psychometric properties of a new instrument (AQoLW) for assessing context-specific features of the academic work and environment that characterized academics' quality of life at work.Method: A 24 item scale was deployed to academics (full, associate, and assistant professors) in a public university in the north of Italy. Items were defined to represent the main academic activities in order to measure if respondents perceived each of it as a challenging or a hindrance demand. The scale was administered online to 1,012 academics, 443 females (48.7%), mean aged 51.1 years (SD = 8.2). In order to test three theoretical models underling AQoLW, a training sample was randomly extracted (242 participants) and analyzed using confirmatory factor analysis (CFA). A validation sample with the remaining 668 participants was used to test the measurement invariance by role of the best model emerging from the training sample.Results: Model fit demonstrate the goodness of a latent structure composed by five intercorrelated factors (CFI = 0.91, RMSEA = 0.08, SRMR = 0.07). Cronbach α of the five subscales was good, ranging from 0.76 to 0.88. The scale overtakes configural invariance, but not strong invariance by role.Conclusions: The scale is able to intercept the mainly dimensions of the academic work that contribute to the quality of life of academics' staff, namely: research and public engagement, didactic work and relationships with students, career development and competition, ordinary obligations, and fund raising. AQoLW is the first tool to evaluate the academic work and its environment, identifying which activities are stressful demands and which are engaging, and promote scholars' satisfaction

Disease awareness in patients with COPD: measurement and extent

Background: Patient awareness of COPD refers to knowledge and acceptance of the disease and its treatment. Although it is relevant to management and outcomes, the disease awareness of patients is poorly investigated, and no validated questionnaires are currently available. We aimed to develop the novel Disease Awareness in COPD Questionnaire (DACQ), which was validated in relation to demographic and clinical features, in patients participating in the SATisfaction and Adherence to COPD Treatment (SAT) study. Methods: DACQ was developed according to a list of items regarding the patient's knowledge, acceptance, and perception of COPD as well as of treatment needs. The questionnaire was validated by assessing internal structure and consistency, correlations with other patient-reported outcomes, and stability over time. Furthermore, the extent of disease awareness of patients enrolled in the SAT study was assessed by using DACQ, and correlations with demographic and clinical features were evaluated. Results: DACQ was composed of four domains. Overall reliability and stability over time were adequate; correlations between DACQ and other tools measuring different constructs (ie, treatment satisfaction, illness perception, impact of COPD symptoms on daily life, and dyspnea severity) were, as expected, more limited. In the enrolled patient sample, a suboptimal level of disease awareness (<70%) was detected, especially in terms of disease acceptance and perception. Disease knowledge was positively associated with COPD severity, while the impact of symptoms on daily life was negatively associated with disease acceptance, awareness of treatment needs, and overall awareness. Conclusion: DACQ proved to be a reliable tool to assess awareness in COPD patients. Awareness of COPD patients need to be improved. Clinical trial registration: ClinicalTrials.gov ID# NCT02689492