An evaluation of the Minnesota living with heart failure questionnaire using Rasch analysis

Purpose The symptom burden of heart failure is significant and impacts upon health-related quality of life. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is widely used in clinical practice to measure self-reported health-related quality of life, but the psychometric properties of the instrument are not fully elucidated. To address this gap, we investigated item and person fit, differential item functioning, item thresholds ordering, targeting and dimensionality of the MLHFQ. Methods Three approaches were used, exploratory factor analysis, Mokken analysis and Rasch analysis, on a convenience sample of 109 participants with a diagnosis of HF from the UK. Participants were typically male (67 %) with a mean age of 68 years (range 41–88). Results Findings from the exploratory factor analysis of the MLHFQ revealed three factors (physical, emotional and social) that explained 72 % of the total variance. Mokken analysis confirmed the MLHFQ total scale, and the three subscales, as valid ordinal scales: the total MLHFQ scale [overall Loevinger coefficient (H) = 0.61], physical scale (H = 0.75), emotional scale (H = 0.79) and social scale (H = 0.552). Rasch analysis confirmed the physical scale as a unidimensional scale, but this was not consistent for the total MLHFQ scale which showed poor fit to the Rasch model (χ 2 = 162), df = 42, p < 0.0001). Six items of the total scale were misfitting (7, 8, 10, 14–16) and removing them improved the fit of the total scale. The physical subscale showed fit to the Rasch model (χ 2 = 20.24, df = 16, p = 0.21), and there was evidence of unidimensionality (t tests = 0.09, lower bound 95 % CI 0.04). There was evidence of disordered thresholds for the MLHFQ total and physical scale, and targeting was poor for both the total scale and its subscales. Conclusion We confirmed the MLHFQ subscales to be valid ordinal scales supporting the use of sum scores to assess quality of life in people diagnosed with HF. Floor effects were evident indicating that the ability of the instrument to identify differences across populations with mild HF may be suboptimal. The psychometric properties of the MLHFQ total scale may be improved by excluding problematic items from the total scale. Further research is warranted to verify findings from this study

Perceived realism moderates the relation between sexualized media consumption and permissive sexual attitudes in Dutch adolescents

This study examined whether the development of sexualized media consumption and permissive sexual attitudes would be more strongly interrelated when adolescents perceived sexualized media images as highly realistic. We used data from a three-wave longitudinal sample of 444 Dutch adolescents aged 13-16 years at baseline. Results from parallel process latent growth modeling multigroup analyses showed that higher initial levels of sexualized media consumption were associated with higher initial level of permissive sexual attitudes. Moreover, increases of sexualized media consumption over time were associated with increases of permissive sexual attitudes over time. Considering the moderation by perceived realism, we found these effects only for those who perceived sexualized media as more realistic. Findings for male and female adolescents were similar except for the relations between initial levels and subsequent development. Among male adolescents who perceived sexualized media images to be realistic, higher initial levels of permissive sexual attitudes were related to subsequent less rapid development of sexualized media consumption. For male adolescents who perceived sexualized media to be less realistic, higher initial levels of sexualized media consumption were related to a subsequent less rapid development of permissive sexual attitudes. These relations were not found for female adolescents. Overall, our results suggest that, in male and female adolescents, those with a high level of perceived realism showed a correlated development of sexualized media consumption and permissive sexual attitudes. These findings point to a need for extended information on how to guide adolescents in interpreting and handling sexualized media in everyday life

Parenting and late adolescents’ well-being in Greece, Norway, Poland and Switzerland : associations with individuation from parents

Cross-cultural studies focusing on individuation and parent-child relationships during late adolescence in the European context are sparse. This study investigated relationships between maternal and paternal responsiveness, demandingness and autonomy granting and late adolescents subjective well-being in Greece, Norway, Poland, and Switzerland. Additionally, the role of psychological, functional, and financial aspects of adolescents’ individuation in these relationships were assessed. Late adolescents (18-20-years-old, N=745) reported on their parents’ behaviors and themselves. Structural models with latent constructs were applied to test the hypothesized relationships. Results showed that in all four countries, maternal and paternal autonomy granting and responsiveness were positively associated with adolescents’ well-being. No significant results were found for demandingness. Further, the study found that psychological and functional connectedness with mothers and financial connectedness with fathers partially explained the associations between parenting behaviors and adolescents’ well-being. The results indicate more similarities than differences across Europe in the associations between parenting on late adolescents’ outcomes. More importantly, the study points out that maternal and paternal parenting may play different roles in late adolescenc