A Validity and Reliability Study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish Patient Population

The importance of trust within health care is widely acknowledged. Measuring patients’ trust in health care systems may contribute to plans for the financing, delivery, and outcomes of health services. Although many scales are available to measure patient trust, less attention has been paid to the multidimensional nature of trust in health care systems. The purpose of this methodological study was to adapt the Multidimensional Trust in Health-Care Systems Scale into Turkish and to evaluate its psychometric properties for a Turkish patient population. The scale was adapted into Turkish through a translation and back-translation process. The content validity of the scale was assessed using expert approval. The psychometric properties of the scale were investigated by collecting data from 232 hospitalised patients in Ankara during theperiod of 1 January–30 December 2010. An exploratory factor analysis identified that the eigenvalues for the three factors of the scale were 7.30, 2.61, and 1.21; these three factors explained 65 % of the variance. A confirmatory factor analysis indicated a sufficient model fit for the construct validity of the scale. Cronbach’s α for the total scale was 0.87, as well as 0.91, 0.82, and 0.61 for the three subscales; the Spearman-Brown split half reliability coefficient was 0.67. Despite the low internal consistency of the subscale 3, evidence from this study supports the validity and reliability of the Multidimensional Trust in Health-Care Systems Scale. This instrument can be used to measure multiple aspects of trust in the health care system; however, as trust is a contextual phenomenon, further work is needed to test the psychometric properties of this scale both in Turkish and different cultures.     

Assessing Adjustment to Aging: A Validation Study for the Adjustment to Aging Scale (AtAS)

Adjustment to aging (AtA) is a multifactor adjustment process with implications on aging well among older adults. The aim of this study was to develop and validate a scale to assess the factors that older adults recognized as indicators of their AtA, with a cross-national comparative perspective towards aging well. Convenience sampling was used to gather questionnaire data, including demographics and the proposed scale. Complete data was available for 1,291 older community-dwelling adults, aged between 75 and 102 years (M = 83.9; SD = 6.68), who represented four different nationalities. Exploratory and confirmatory factor analyses were performed for dimension reduction and exploration of the factorial structure. Data gathered with the 22-items AtA five-factor scale showed overall good psychometric properties (in terms of distributional properties, statistical significant factor weights, factorial, convergent, discriminant criterion and external-related validities, as well as reliability). Five factors were selected for the Adjustment to Aging Scale: (a) sense of purpose and ambitions (b) zest and spirituality; (c) body and health; (d) aging in place and stability; and (e) social support. We present a 22-item scale with five factors for AtA estimation in a cross-national elderly population which produced valid and reliable data for elder persons from four different nationalities. Results showed that this scale is an adequate cross-cultural instrument for research, clinical practice and program development in the health care context. These may benefit from clearly understanding AtA as an important component for reducing health disparities and for aging well, across nationalities.     

Connecting older grandmothers raising grandchildren with community resources improves family resiliency,social support,and caregiver self-efficacy

Custodial grandparenting can be especially challenging for older grandmothers facing age specific issues. Kinship navigator programs are social service delivery programs intended to inform grandparents and other relatives raising children about available resources and services, provide information specific to their individual needs, and help families navigate service systems. Our study utilizes self-report data from one kinship navigator federal demonstration project, which used a randomized control trial, to examine demographic characteristics for grandmothers under and over 55 years of age, whether grandmother caregivers (≥55 years) improve family resilience, social support, and caregiver self-efficacy, and which interventions improved outcomes for grandmothers (≥55 years). Each participant was randomly assigned to one of four groups: Usual Care (traditional child welfare services), Standard Care (family support and case management), Peer-to-Peer Care Only, and Full Kin Tech Care (peer navigators with computer access and interdisciplinary team). Thirty-nine percent of grandmothers (55-75 years) were mostly living in poverty, predominantly Caucasian, with 36% identifying as African American/Black, with at least one to two children at home. Repeated-measures ANOVAs for each subscale showed statistically significant within- and between-group differences for Family Functioning, Social Supports, Concrete Supports, Child Development, and Nurturing and Attachment, with the exception of Usual Care, which showed a decline in protective factors consistently across subscales. Future research with kinship families could qualitatively examine the experiences for older women in navigator programs and replication of kinship navigator programs could build capacity in data collection and maintenance systems to gain better perspective about how systems of care impact families.     

Cross-Cultural Adaptation,Validity and Reliability of the Escala Pessoal de Resultados

The present article aims to examine the validity and reliability of the Portuguese version of Personal Outcomes Scale the Escala Pessoal de Resultados (EPR). This scale represents an instrument to measure the quality of life (QOL) in people with intellectual disabilities (ID). The study was initiated with the application of international guidelines in cross-cultural adaptation, culminating with an evaluation of 10 experts for the quantitative evidence of the content validity. All EPR’s items were considered relevant and there was a moderated agreement (k > .40) among the experts in the calculation of Cohen’s kappa, finding some coefficients’ that are considered as an excellent agreement (k > .75). In test field, our sample comprised 335 adults with ID on level of intermittent and limited support needs, even as the respective proxies. The scale showed an excellent internal consistency (α = .94). EPR’s construct validity indexes are also reported and discussed. The study provides EPR as a valid instrument for assess the QOL in ID field, and the scale seems to be useful for improvement of Portuguese rehabilitation practices and services.     

Development and Validation of a Measure of Living Standards for Older People

Living standards are an effective way to assess socioeconomic status in relation to health but controversy remains about their assessment, particularly for older people. Sen’s capability framework shifts attention from material conditions to opportunities for choice enabled by material resources. To develop this promising approach, this paper reports on the development of a measure of living standards for older people based on Sen’s capability framework. Six living standards domains were established from thematic analysis of 143 interviews with people aged over 65 years in New Zealand. Questionnaire items were developed and tested to assess the extent to which older people had the freedom to pursue these domains. The 73 items were tested for face validity in interviews. Following this, a revised version was posted to 2,000 people aged over 65 years randomly selected from the New Zealand electoral roll and 1,064 completed questionnaires were returned. Item screening for response rates and spread reduced the items to 34. Confirmatory factor analysis of these 34 items suggested that the six theoretical domains were supported. Following model development, 25 items assessing the six domains were selected. Results to date show that this measure of living standards (LS-Cap) is a promising instrument to assess living standards as the freedom to access valued needs.     

Developing an instrument to measure satisfaction with continuity of midwifery care drawing on the Delphi technique

BackgroundMaternal satisfaction with maternity care is an important indicator of quality maternity services. Continuity of midwifery models of care are increasing in Australia and while several instruments have been developed to measure satisfaction with maternity care most of these have not been validated and there are none that are appropriate to continuity of midwifery maternity care models.AimTo develop a questionnaire to measure women’s satisfaction with maternity services provided in a continuity of midwifery care service model.MethodsA modified Delphi technique was used. A heterogenous panel of eight experts provided feedback over four rounds. The starting point for the questionnaire was informed by two systematic literature reviews focusing on available instruments for measuring maternal satisfaction with maternity care and what women value continuity of midwifery models of care.FindingsThe Continuity of Midwifery Care Satisfaction Survey (COMcareSS) was developed after four rounds of feedback with the expert panel. The survey comprises nine domains and fifty-nine questions. The domains include demographics, maternity care outcomes, facilities, the midwife/woman relationship, building capacity-empowerment, decision making and involvement, personalised care, advice care and support and general.ConclusionsConsumer satisfaction is an important indicator of quality care. This is the first instrument to be developed that is appropriate to continuity of midwifery models of care. The important next step is to pilot test the instrument to establish its validity and reliability.     

The emotional and professional wellbeing of Australian midwives: A comparison between those providing continuity of midwifery care and those not providing continuity

Background

Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.

Reliability and Validity of the Personal Social Capital Scale 16 and Personal Social Capital Scale 8: Two Short Instruments for Survey Studies

Rapid developments in social capital and health research require short instruments for large-scale survey studies. The Personal Social Capital Scale (PSCS) is a theory-based and empirically tested instrument with reliability and validity established in the US and China, but it is too long for large-scale survey research. In this study, we described two short versions of the instrument: the PSCS-16 and PSCS-8. The two short scales were evaluated with survey data collected among an adult sample (N = 259) in China. The sample consisted of rural-to-urban migrants and non-migrant rural and urban residents. Cronbach’s alpha coefficients were .90 for the PSCS-18 and .83 for the PSCS-8. Both short instruments satisfactorily fit a two-factor model comprising the bonding capital and bridging capital subscales. The two short scales were highly correlated with the original PSCS (r = .95 for the PSCS-18 and .93 for the PSCS-8 respectively, p < .001 for both); significantly distinguished the migrant subsample from the two non-migrant subsamples; and significantly predicted social capital investment and stress level. In conclusion, the two short instruments PSCS-16 and PSCS-8 were reliable and valid, and can be used in large-scale survey studies to assess personally owned social capital. Further research is needed to replicate their reliability and validity in different cultural settings and to establish the test–retest reliability.     

Assessing Subjective Well-being in Chinese Older Adults: The Chinese Aging Well Profile

Subjective well-being has increasingly been used as a key indicator of quality of life in older people. Existing evidence shows that it is likely that eastern cultures carry different life values and so the Chinese Aging Well Profile was devised for measuring subjective well-being in Chinese adults (50+). Data was collected from 1,906 community-dwelling Chinese (50+) in Taiwan in six sequential stages, involving qualitative interviews and psychometric testing. Seven key dimensions of subjective well-being identified in the interviews provided an item bank for instrument construction. The 31-item Chinese Aging Well Profile comprised seven subscales–’physical’, ‘psychological’, ‘independence’, ‘learning & growth’, ‘material’, ‘environmental’, and ‘social’ well-being. The study indicated that elements of subjective well-being are common across western and eastern cultures but are interpreted and weighted differently. This new instrument has demonstrated preliminary evidence for reliability and validity and that it is suitable for use in the Chinese speaking older population.     

Sleep quality at 3 months postpartum considering maternal age: A comparative study

Background

Poor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors.

Assessing Experiences With LGBT Microaggressions in the Workplace: Development and Validation of the Microaggression Experiences at Work Scale

ABSTRACT

LGBT people experience microaggressions in the workplace; however, limited research exists in this area partly due to a lack of psychometrically sound instruments measuring the prevalence of LGBT microaggressions in the workplace. To address this gap, an empirical study was conducted and the LGBT-MEWS was created and tested. The LGBT-MEWS is a 27-item self-report scale comprising three subscales. Each subscale conceptually represents a different domain through which microaggressions impact LGBT employees: (1) workplace values, (2) heteronormative assumptions, and (3) cisnormative culture. The results of testing indicated that the subscales demonstrate strong reliability and validity.     

Sexual Prejudice in Sport Scale: A New Measure

ABSTRACT

This study describes the process of developing and validating the Sexual Prejudice in Sport Scale (SPSS), which is a multidimensional instrument developed to assess attitudes toward lesbians and gay men (LG) in sports. The authors conducted two studies: first, to establish the factor structure of the SPSS on 297 heterosexual athletes; and, second, to test the reliability and validity of the resulting 19-item scale on a sample of 311 heterosexual and 160 LG athletes. Exploratory factor analysis of an initial item pool yielded three factors: open rejection, which assesses the blatant prejudice expressed toward LG people; denial of visibility, which evaluates attitude toward the coming out of LG people; and gendering performance, which corresponds to gender stereotypes about performance/skills of LG people. A confirmatory factor analysis was conducted to assess the stability of the SPSS. The authors documented internal consistency, test-retest stability, and convergent/divergent validity. Implications and directions for future research are discussed.     

Fall-related injuries in Amsterdam: Frail older women at risk

ABSTRACT

Unintentional falls are a common cause of injury, especially among older persons. This study evaluates risk factors such as gender and age on morbidity and mortality after unintentional falls. Data were collected retrospectively for patients with a unintentional fall who were presented to the emergency department in 2013. A total of 3,217 patients were included; the majority were female. Patients over 65 years of age had a significant higher mortality and a longer length of hospital stay. Older women are at risk for sustaining a fall-related injury. Female gender is furthermore associated with increased length of stay in the hospital. Prevention should focus especially on these frail patients.     

Measuring older women’s resilience: Evaluating the suitability of the Connor-Davidson Resilience Scale and the Resilience Scale

ABSTRACT

The author provides conceptual and operational definitions of the construct of resilience in the context of research with older adults (aged 60 years or older). Two psychometric instruments (the Connor-Davidson Resilience Scale and the Resilience Scale) are described. The psychometric properties of each instrument are discussed in relation to the research of the original developers of the tools and research conducted by other investigators. Research on the resilience of older women has yet to be initiated. The author evaluated the psychometric properties of both instruments to determine their suitability for investigation of resilience in older women.     

Cultivating Professional Allies for Sexual Minority Youth: A Community-Based Educational Intervention

Sexual minority youth (SMY) face multiple risks in their daily lives that may influence their need for supportive care. Health and social service providers have unique opportunities to provide culturally competent services to these youth. This article describes a community-based educational intervention created to increase providers’ knowledge, skills, and intention to support SMY. Based on the Information-Motivation-Behavioral Skills model, this pilot study found that for a diverse sample of multidisciplinary professionals (n = 2,850), the odds of behavioral intention (BI) to support SMY were significantly higher when trainings were relevant to the professionals’ experience (OR = 1.3), were sensitive (OR = 1.3), developed skills (OR = 1.1), and incorporated policy (OR = 1.2). Implications for the delivery of community-based trainings are provided.     

Techniques For Developing Health Quality of Life Scales for Point of Service Use

Clinical and health policy research frequently involves health status measurement using generic or disease specific instruments. These instruments are generally developed to arrive at several scales, each measuring a distinct domain of health quality of life (HQOL). Clinical settings are starting to explore how to integrate patient perspectives of HQOL outcomes into patient care. However, the length of many HQOL instruments poses a challenge in terms of patient burden, as well as clinic flow time. The most popular paradigm for scale construction utilizes classical test theory methodology and can lead to excessive and redundant items in an effort to bolster reliability measurements such as Cronbach’s alpha above levels of accepted reliability. This paper presents techniques for utilizing item response theory to arrive at single item scales that are diagnostically informative and short enough to have clinical utility. A danger of such dramatic scale reduction is that validity might be compromised. This danger is addressed in terms of criterion related validity and sensitivity to clinical changes over a 36 months period. The reduction methods are illustrated using selected scales from the Arthritis Impact Measurement Scales 2 (AIMS2) with data obtained from the study Pharmaceutical Care Outcomes: The Patient Role (PCOPR).     

Common Factors That Enhance the Quality of Life for Women Living in Their Own Homes or in Aged Care Facilities

A qualitative study of older women living in their own homes and older women living in aged care facilities found that the concerns of the women living in their own homes were the realities of life for the residents in the aged care facilities. Twenty-five female residents across two facilities and 11 older women living in their own homes were interviewed. The positive outcomes of aging at home are relevant and desirable for residents of aged care facilities. A smooth transition from community living to residential aged care involves retaining some of these positive aspects of their lives.     

Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners

Problem

The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up.