Validity, reliability and responsiveness of the "Schedule for the Evaluation of Individual Quality of Life – Direct Weighting" (SEIQoL-DW) in congenital heart disease

BACKGROUND: The 'Schedule for the Evaluation of Individual Quality of Life – Direct Weighting' (SEIQoL-DW) is an instrument developed to measure individual quality of life. Although this instrument has been used in numerous studies, data on validity and reliability are sparse. This study aimed to examine aspects of validity, reliability and responsiveness of the SEIQoL-DW on data obtained in adults with congenital heart disease, by using the new standards of psychological testing. METHODS: We evaluated validity evidence based on test content, internal structure, and relations to other variables, as well as the stability and responsiveness of the SEIQoL-DW. Evidence was provided by both theoretical considerations and empirical data. Empirical data were acquired from two studies. Firstly, using a cross-sectional study design, we included 629 patients with congenital heart disease. Secondly, 130 of the 629 initially included patients readministered the questionnaires approximately one year after the first data collection. In addition to the SEIQoL-DW, linear analog scales were used to assess overall quality of life and perceived health. RESULTS: We found that the SEIQoL-DW is not a valid measure of quality of life, but rather assesses determinants that contribute to individuals' quality of life. The SEIQoL-DW consistently proved to be valid and reliable to assess those determinants. However, responsiveness in patients with congenital heart disease may be problematic. CONCLUSION: Based on theoretical and empirical considerations, the SEIQoL-DW cannot be considered as a quality of life instrument. Nonetheless, it is a valid and reliable instrument to explore determinants for patients' quality of life

Validity and reliability on three European language versions of the Safety Organizing Scale

Background The Safety Organizing Scale (SOS) offers a reliable snapshot of nurses' engagement in unit-level safety behaviors in hospitals. As no comparable questionnaire exists in German, French and Italian, we explored the psychometric properties of SOS translations into each of those languages. Design and Methods The psychometric properties of the nine-item SOS were tested according to American Educational Research Association guidelines. Subjects and Setting Between October 2009 and June 2010, 1633 registered medical and/or surgical nurses in 35 Swiss hospitals completed translated SOS questionnaires. Results For each translation, psychometric evaluation revealed evidence based on content (scale-content validity index >0.89), response patterns (e.g. average of missing values across all items = 0.80%), internal structure (e.g. comparative fit indices >0.90, root mean square error of approximation 0.79). We differentiated the scale regarding one related concept (implicit rationing of nursing care). Higher SOS scores correlated with supportive leadership and lower nurse-reported medication errors, but not with nurse-reported patient falls. Conclusions The SOS offers a valuable measurement of engagement in safety practices that might influence patient outcomes. Initial evidence regarding the validity and reliability of the translated versions supports their use in German, French and Italian. Concurrent validity will require confirmation via further analysis using more reliable outcome measures (e.g. mortality rates). The translated versions' predictive validity needs to be established in prospective studie

How Accurate Are Electronic Monitoring Devices? A Laboratory Study Testing Two Devices to Measure Medication Adherence

In a prospective descriptive laboratory study, 25 Helping Hand™ (HH) (10 without and 15 with reminder system) and 50 Medication Event Monitoring Systems (MEMS) (25 with 18-month and 25 with 2-year battery life) were manipulated twice daily following a predefined protocol during 3 consecutive weeks. Accuracy was determined using the fixed manipulation scheme as the reference. Perfect functioning (i.e., total absence of missing registrations and/or overregistrations) was observed in 70% of the HH without, 87% of the HH with reminder, 20% MEMS with 18 months, and 100% with 2-year battery life respectively

Associations between rationing of nursing care and inpatient mortality in Swiss hospitals

Objectives To explore the relationship between inpatient mortality and implicit rationing of nursing care, the quality of nurse work environments and the patient-to-nurse staffing ratio in Swiss acute care hospitals. Design Cross-sectional correlational design. Setting Eight Swiss acute care hospitals examined in a survey-based study and 71 comparison institutions. Participants A total of 165 862 discharge abstracts from patients treated in the 8 RICH Nursing Study (the Rationing of Nursing Care in Switzerland Study) hospitals and 760 608 discharge abstracts from patients treated in 71 Swiss acute care hospitals offering similar services and maintaining comparable patient volumes to the RICH Nursing hospitals. Main outcome measures The dependent variable was inpatient mortality. Logistic regression models were used to estimate the effects of the independent hospital-level measures. Results Patients treated in the hospital with the highest rationing level were 51% more likely to die than those in peer institutions (adjusted OR: 1.51, 95% CI: 1.34-1.70). Patients treated in the study hospitals with higher nurse work environment quality ratings had a significantly lower likelihood of death (adjusted OR: 0.80, 95% CI: 0.67-0.97) and those treated in the hospital with the highest measured patient-to-nurse ratio (10:1) had a 37% higher risk of death (adjusted OR: 1.37, 95% CI: 1.24-1.52) than those in comparison institutions. Conclusions Measures of rationing may reflect care conditions that place hospital patients at risk of negative outcomes and thus deserve attention in future hospital outcomes research studie

How hospital leaders contribute to patient safety through the development of trust

The aim of this study was to explore the associations between hospital management support for patient safety, registered nurses' trust in hospital management, and their overall perception of patient safety, considering aspects of safety communication as possible mediating variables.; Limited research exists regarding how key elements of a patient safety culture, that is, leadership, safety communication, and trust, are interrelated.; This study used cross-sectional nurse survey data from 1,633 registered nurses working in 35 acute care hospitals participating in the Swiss arm of the RN4CAST (Nurse Forecasting in Europe) study.; A path analysis revealed that the indirect associations between "management support for patient safety" and "overall perception of patient safety" were more prominent than the direct association.; Our findings confirm that safety communication plays a partially mediating role between "management support for patient safety" and nursing professionals' assessments of patient safety. This suggests that hospital leader-unit exchanges might improve patient safety

A master of nursing science curriculum revision for the 21st century : a progress report

Background: Preparing a 21st century nursing workforce demands future-oriented curricula that address the population’s evolving health care needs. With their advanced clinical skill sets and broad scope of practice, Advanced Practice Nurses strengthen healthcare systems by providing expert care, especially to people who are older and/or have chronic diseases. Bearing this in mind, we revised our established Master of Nursing Science curriculum at the University of Basel, Switzerland. Methods: Guided by the Advanced Nursing Practice framework, interprofessional guidelines, fundamental reports on the future of health care and the Bologna declaration, the reform process included three interrelated phases: preparation (work packages (WPs): curriculum analysis, alumni survey), revision (WPs: program accreditation, learning outcomes), and regulations (WPs: legal requirements, program launch). Results: The redesigned MScN curriculum offers two specializations: ANP and research. It was implemented in the 2014 fall semester. Conclusions: This curriculum reform’s strategic approach and step-by-step processes demonstrate how, beginning with a solid conceptual basis, congruent logical steps allowed development of a program that prepares nurses for new professional roles within innovative models of care

Weight gain, overweight and obesity in solid organ transplantation - a study protocol for a systematic literature review

BACKGROUND: Overweight and obesity, which have a substantial impact on health in the general population, have similar prevalence in solid organ transplant recipients but carry even more serious ramifications. As this group's use of immunosuppressive medication increases the risk for comorbidities, e.g. metabolic syndrome and cardiovascular disease, the prevention of additional risk factors is vital. This systematic review will be the first to summarize the issue of weight gain, overweight and obesity concurrently within and across solid organ transplantation. The three research questions relating to solid organ transplantation are the following: (1) What are the prevalence and evolution of overweight and obesity from pre- to post-transplant?; (2) Which pre- and post-transplant risk factors are associated with post-transplant weight gain, overweight or obesity? and (3) Which post-transplant patient outcomes and comorbidities are associated with pre- and post-transplant weight gain, overweight and obesity? METHODS/DESIGN: MEDLINE via PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO and Excerpta Medica DataBase (EMBASE) will be searched for original quantitative studies in adult liver, heart, lung or kidney transplant patients. Topics of interest will be the prevalence and evolution of overweight and obesity over time, risk factors associated with changes in weight or body mass index (BMI), overweight and obesity, and the relationship of weight or BMI with post-transplant outcomes and comorbidities. Screening of titles and abstracts, full-text reading and data extraction will be divided between three researchers. Researchers will cross-check one another's screening decisions for random samples of studies to adhere as closely as possible to the recommendations of The Cochrane Collaboration. For quality assessment, a purpose-adapted 19-item instrument will be used. Effect sizes will be calculated for relationships investigated in a minimum of five studies. Random effects meta-analysis with moderator analyses will be conducted if applicable. DISCUSSION: This systematic review will comprehensively synthesize the existing evidence concerning weight gain, overweight and obesity in solid organ transplantation in view of magnitude, influencing factors and associations with patient outcomes and comorbidities. The results can fuel the development of interventions to prevent weight gain in the solid organ transplant population. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42014009151

Validity and reliability on three European language versions of the Safety Organizing Scale

Background: The Safety Organizing Scale (SOS) offers a reliable snapshot of nurses' engagement in unit-level safety behaviors in hospitals. As no comparable questionnaire exists in German, French and Italian, we explored the psychometric properties of SOS translations into each of those languages. Design and Methods: The psychometric properties of the nine-item SOS were tested according to American Educational Research Association guidelines. Subjects and Setting: Between October 2009 and June 2010, 1633 registered medical and/or surgical nurses in 35 Swiss hospitals completed translated SOS questionnaires. Results: For each translation, psychometric evaluation revealed evidence based on content (scale-content validity index >0.89), response patterns (e.g. average of missing values across all items = 0.80%), internal structure (e.g. comparative fit indices >0.90, root mean square error of approximation 0.79). We differentiated the scale regarding one related concept (implicit rationing of nursing care). Higher SOS scores correlated with supportive leadership and lower nurse-reported medication errors, but not with nurse-reported patient falls. Conclusions: The SOS offers a valuable measurement of engagement in safety practices that might influence patient outcomes. Initial evidence regarding the validity and reliability of the translated versions supports their use in German, French and Italian. Concurrent validity will require confirmation via further analysis using more reliable outcome measures (e.g. mortality rates). The translated versions' predictive validity needs to be established in prospective studies