Confirmatory Factor Analysis of Scales Measuring Trust,and Control-Self-efficacy of Young Iranian Women

This study is among the first to assess Trust and Control-Self-efficacy scales as measures of cognitive social capital in transitional societies such as Iran. 391 Iranian young women aged between 18 and 35 years (M 27.3, SD 4.8) were recruited at ten sites in the city of Shiraz by cluster convenience sampling to participate in this cross-sectional study. The measures used included “Trust” and “Control-Self-efficacy” scales adapted from the British General Household Survey social capital survey. Confirmatory factor analysis with Structural Equation Modelling was used to assess the model adequacy. In addition, reliability and validity of the model was measured. After assessing all possible models to yield the best fit for the data, the “Trust” scale model represents a change of structure from three subscales to four subscales which provided a best fit with the data (χ² = 2.231, RMSEA = 0.056). While for “Control-Self-efficacy” scale with three subscales, five items were deleted in order to have a fit model (χ² = 2.128, RMSEA = 0.054). As a result, the collective evidence suggested that the instrument includes relevant items for its target population and can be a reliable and valid measure for the population of interest.

     

Trust in American Government: Longitudinal Measurement Equivalence in the ANES, 1964–2008

For over 50 years (1958–2012) the American National Election Studies (ANES) survey has been measuring citizens’ evaluations of the trustworthiness of the “government in Washington”—an indicator that has been widely used to monitor the dynamics of political trust in the US over time. However, a critical assumption in using attitudinal constructs for longitudinal research is that the meaning-and-interpretation of such items should be comparable across groups of respondents at any one point in time and across samples over time. Using multigroup confirmatory factor analysis for ordered-categorical data, we test the measurement equivalence assumption with data collected by the ANES from 1964 to 2008. The results confirm that the ANES’ political trust scale has the same basic factorial structure over time. But for two key items, several threshold parameters were found to be different across time points, indicating that the meaning-and-interpretation of these questions, and especially the question about whether the government in Washington wastes money that people pay in taxes, varies significantly over time.

     

A Psychometric Review of Measures Assessing Discrimination Against Sexual Minorities

ABSTRACT

Discrimination against sexual minorities is widespread and has deleterious consequences on victims’ psychological and physical wellbeing. However, a review of the psychometric properties of instruments measuring lesbian, gay, and bisexual (LGB) discrimination has not been conducted. The results of this review, which involved evaluating 162 articles, reveal that most have suboptimal psychometric properties. Specifically, myriad scales possess questionable content validity as (1) items are not created in collaboration with sexual minorities; (2) measures possess a small number of items and, thus, may not sufficiently represent the domain of interest; and (3) scales are “adapted” from measures designed to examine race- and gender-based discrimination. Additional limitations include (1) summed scores are computed, often in the absence of scale score reliability metrics; (2) summed scores operate from the questionable assumption that diverse forms of discrimination are necessarily interrelated; (3) the dimensionality of instruments presumed to consist of subscales is seldom tested; (4) tests of criterion-related validity are routinely omitted; and (5) formal tests of measures’ construct validity are seldom provided, necessitating that one infer validity based on the results obtained. The absence of “gold standard” measures, the attendant difficulty in formulating a coherent picture of this body of research, and suggestions for psychometric improvements are noted.     

Sliders,visual analogue scales,or buttons: Influence of formats and scales in mobile and desktop surveys

ABSTRACT

In an experiment dealing with the use of personal computer, tablet, or mobile, scale points (up to 5, 7, or 11) and response formats (bars or buttons) are varied to examine differences in mean scores and nonresponse. The total number of “not applicable” answers does not vary significantly. Personal computer has the lowest item nonresponse, followed by mobile and tablet, and a lower mean score than for mobile. Slider bars showed lower mean scores and more nonresponses than buttons, indicating that they are more prone to bias and difficult in use. Sider bars, which work with a drag-and-drop principle, perform worse than visual analogue scales working with a point-and-click principle and buttons. Five-point scales have more nonresponses than eleven-point scales. Respondents evaluate 11-point scales more positively than shorter scales.     

Attitude strength moderates adverse effects to questionnaire design

ABSTRACT

The presentation and visual design of the “don’t know” category in rating scales on respondents’ behavior may have ambivalent effects. The hypothesis is that attitude strength toward the topic influences the respondents’ sensitivity to the graphical design of the scale. A paper-and-pencil questionnaire conducted among 307 German university students contained an experimental variation of the presentation of a “don’t know” category and its visual design. A multinomial logistic regression shows that presenting a “don’t know” category drives respondents toward extreme categories. The visual design of the “don’t know” category influences the distribution of responses, all the more that the respondents’ attitudes toward the item topic are weak.     

Linearity,symmetry, and equidistance in semantic differential scales for measuring images of self and images of others

ABSTRACT

Violations of linearity, symmetry, and equidistance of scale points in semantic differential scales may be due to respondents failing to figure out antonyms, to a positivity bias, or to respondents curtailing their reading the options. Multiple correspondence analysis on data provided by a randomized between-subjects experiment (split-ballot), using a web survey of 537 German residents, shows that bipolar semantic differential scales allow for linear measurement and conceal no positivity bias, and that using not suitable adjective pairs in semantic differential scales destroys symmetry.     

Dealing with omitted answers in a survey on social integration of immigrants in Italy

ABSTRACT

Surveys are used to infer the level of social integration of immigrants. Item response theory helps to describe the relationship among responses to test items and latent traits of interest. However, in the presence of nonignorable missing data, which are omitted responses depending on the latent traits to be measured, estimates of the model parameters are biased. To account for nonignorable missing data, the quantity and quality of contacts between immigrants and natives (so called “social integration”) are taken into account through a linear function of the response propensity. Higher education, no intention to migrate again, young age, Albanian nationality, and declaring a non-Muslim religion or none, comparatively favor social integration.     

How Cognitive Interviewing can Provide Validity Evidence of the Response Processes to Scale Items

The current theory about validity reflected in the Standards for Educational and Psychological Testing (AERA et al. in Standards for educational and psychological testing, American Psychological Association, Washington, DC, 1999), offers no clear indications about the methods for gathering validity evidence about the response processes. Cognitive interviewing (CI) can play an important role answering the current demand about empirical and theoretical analyses of the response processes as a source of validity evidence in psychological testing. CI can provide validity evidence for investigating substantive aspects of construct validity and for contributing to the explanations for item and test scores (Zumbo in Handbook of statistics, vol 26, Elsevier, Amsterdam, pp. 45–79, 2007; The concept of validity: revisions, new directions and applications, IAP—Information Age Publishing Inc., Charlotte, NC, pp. 65–82, 2009). The aim of the study was to illustrate the use of cognitive interviewing method for gathering validity evidence on response processes. The search for evidence about the “response process” was guided by an argument-based approach to validity (Kane in Psychological Bulletin 1992; Educational measurement, American Council on Education/Praeger, Washington, DC, pp. 17–64, 2006). 21 cognitive interviews were carried out during the cognitive testing of the APGAR psychological scale intended to measure the “family support” construct. Cognitive interviewing provided validity evidence that explains how respondents interpret and respond to the APGAR items. Respondents maintained a shared interpretation of “family concept” while answering the APGAR scale items. Nevertheless, they included in the concept of family not only family members they live with but also other family members and even friends. CI participants were also capable of classifying their answers about the family support perception following a polythomous response system. Lastly, the role of CI in the Kane’s argument-based approach and Zumbo’s contextualized view of validity will be discussed.     

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).     

Quality of life as a concept and measurable entity

This chapter proposes that “quality of life” (QOL) is a multidimensional concept, the measurement of which must contain objective elements of a person's life. It is further suggested that in the development of QOL measurement instruments the selection of items must be influenced significantly by the views of the population under study. Instruments to measure quality of life have been flawed owing to their inadequate conceptual bases and the attempts to utilise general measures which are often the “broad brush” to detect changes in disease specific situations. The chapter outlines conceptual approaches to quality of life and provides an analysis of a range of definitions. It provides an overview of a number of approaches to measure QOL in specific populations. Finally, it addresses some of the potential uses and abuses involved in the measurement of QOL. The whole of science is nothing more than a refinement of everyday thinking. (Albert Einstein, 1950, p. 59)      

What women want and why. Women's preferences for induction of labour or expectant management in late-term pregnancy

BackgroundBoth induction of labour at 41 weeks and expectant management until 42 weeks are common management strategies in low-risk pregnancy since there is no consensus on the optimal timing of induction in late-term pregnancy for the prevention of adverse outcomes. Our aim was to explore maternal preference for either strategy and the influence on quality of life and maternal anxiety on this preference.MethodsObstetrical low-risk women with an uncomplicated pregnancy were eligible when they reached a gestational age of 41 weeks. They were asked to fill in questionnaires on quality of life (EQ6D) and anxiety (STAI-state). Reasons of women's preferences for either induction or expectant management were explored in a semi-structured questionnaire containing open ended questions.ResultsOf 782 invited women 604 (77.2%) responded. Induction at 41 weeks was preferred by 44.7% (270/604) women, 42.1% (254/604) preferred expectant management until 42 weeks, while 12.2% (74/604) of women did not have a preference. Women preferring induction reported significantly more problems regarding quality of life and were more anxious than women preferring expectant management (p < 0.001). Main reasons for preferring induction of labour were: “safe feeling” (41.2%), “pregnancy taking too long” (35.4%) and “knowing what to expect” (18.6%). For women preferring expectant management, the main reason was “wish to give birth as natural as possible” (80.3%).ConclusionWomen's preference for induction of labour or a policy of expectant management in late-term pregnancy is influenced by anxiety, quality of life problems (induction), the presence of a wish for natural birth (expectant management), and a variety of additional reasons. This variation in preferences and motivations suggests that there is room for shared decision making in the management of late-term pregnancy.     

Exploring unwarranted clinical variation: The attitudes of midwives and obstetric medical staff regarding induction of labour and planned caesarean section

BackgroundUnexplained clinical variation is a major issue in planned birth i.e. induction of labour and planned caesarean section.AimTo map attitudes and knowledge of maternity care professionals regarding indications for planned birth, and assess inter-professional (midwifery versus medical) and intra-professional variation.MethodsA custom-created survey of medical and midwifery staff at eight Sydney hospitals. Staff were asked to rate their level of agreement with 45 “evidence-based” statements regarding caesareans and inductions on a five-point Likert scale. Responses were grouped by profession, and comparisons made of inter- and intra-professional responses.FindingsTotal 275 respondents, 78% midwifery and 21% medical. Considerable inter- and intra-professional variation was noted, with midwives generally less likely to consider any of the planned birth indications “valid” compared to medical staff. Indications for induction with most variation in midwifery responses included maternal characteristics (age≥40, obesity, ethnicity) and fetal macrosomia; and for medical personnel in-vitro fertilisation, maternal request, and routine induction at 39 weeks gestation. Indications for caesarean with most variation in midwifery responses included previous lower segment caesarean section, previous shoulder dystocia, and uncomplicated breech; and for medical personnel uncomplicated dichorionic twins. Indications with most inter-professional variation were induction at 41+ weeks versus 42+ weeks and cesarean for previous lower segment caesarean section.DiscussionBoth inter- and intra-professional variation in what were considered valid indications reflected inconsistency in underlying evidence and/or guidelines.ConclusionGreater focus on interdisciplinary education and consensus, as well as on shared decision-making with women, may be helpful in resolving these tensions.     

The Evaluation of a Self-enumerated Scale of Quality of Life (CASP-19) in the Context of Research on Ageing: A Combination of Exploratory and Confirmatory Approaches

This paper describes the conceptual development of a self-enumerated scale of quality of life (CASP-19) and presents an empirical evaluation of its structure using a combination of exploratory and confirmatory factor analytic approaches across three different survey settings for older people living in England and Wales in the new millennium. All evaluations are conducted using MPlus which allows the analyst to evaluate the properties of the scale for a set of multivariate categorical items which are subject to item non-response. CASP-19 is a subjective measure of well-being derived from an explicit theory of human need spanning four life domains: control, autonomy, self-realisation and pleasure. Put formally, CASP-19 is a self-reported summative index consisting of 19 Likert scale items. The three survey settings include a postal survey of 263 people in early old age followed up from childhood when the respondents were first interviewed in the 1930's, the first wave (2002) of the English Longitudinal Study of Ageing (ELSA_1) and the eleventh wave of the British Household Panel Survey (BHPS_11) also conducted in 2002. These nationally representative surveys consisted of 9300 and 6471 respondents aged 55 years and older. The Boyd-Orr sample provides an exploratory context for the evaluation and ELSA_1 together with BHPS_11 provide the opportunity for confirmatory analyses of three measurement models. There is some support for the use of CASP-19 as a stand alone summative index. However, the analysis reveals that a shortened 12-item scale which combines the life domains 'control and autonomy' in a second order measurement model is the recommended model for analysts. The work was funded under the UK's Economic and Social Research Council's Growing Older Programme and their Priority Network on Human Capability and Resilience. Grant Nos. L480254016 & L326253061.

Perceptions of “Impingement” and Marital Satisfaction Among Wives of Retired Husbands

ABSTRACT

Initial pilot interviews with women whose husbands were in the first year of retirement revealed that problems of “impingement”—perceptions of husbands as intruders into their worlds-as-lived—were cited, in response to open-ended items, as the most difficult aspect of husbands' retirement. An impingement index, consisting of items constructed from those responses, was administered to the original panel of 83 women whose husbands were now in the fourth year of retirement, and to a new panel of 61 women whose husbands had been retired for one year. Paired T-tests revealed one significant difference in perceptions of impingement between the two groups of wives, and not in the expected direction. Indeed, wives in year 4 were more often bothered by some impingement conditions than wives in year 1, and these were significantly related to self-assessments of marital satisfaction. Results have implications for “adjustment” to life transitions, including situations that may inhibit initiation of adaptive responses, degree of investment in social roles, and issues of expectation.     

The Measurement of Ethnic and Religious Divisions: Spatial,Temporal, and Categorical Dimensions with Evidence from Mindanao,the Philippines

Survey research on subjective wellbeing in The Netherlands started in the early 1970s. The time series happiness and life satisfaction that have emerged since then are unfortunately based on slightly different survey items of which one part uses verbal response scales and another part uses numerical response scales. The diversity of the survey items and a number of other measurement issues, such as the effects of changes in survey mode, hamper comparison over time and make it difficult to establish whether life became any better over the last forty years. These problems can be tackled using the recently developed Reference Distribution Method with which responses to equivalent but not identical survey questions can be pooled to obtain long, consistent time series. We applied the Reference Distribution method to pool time series of happiness and life satisfaction. We conclude that in the past 40 years the Dutch have become slightly happier and satisfied with their lives.     

Development of a tool to measure holistic reflection in midwifery students and midwives

BackgroundHolistic reflection encompasses reflection as a continuum, incorporating critical reflection, reflexivity, critical thinking and a whole-of-person approach. The development of holistic reflection in midwifery students and midwives is rarely measured in a standardised way.AimTo develop and test a tool to measure holistic reflection in midwifery students and midwives, for use in pre-registration and post-graduate education, and research.DesignThe eight-step approach to tool development by DeVellis was followed with psychometric testing of data from a cross-sectional survey.ParticipantsMidwifery students (pre-registration and postgraduate), and midwifery alumni of an Australian university.MethodsDraft items (n = 84) were generated from review of the literature, qualitative research, and a theoretical model. An expert panel (n = 19) reviewed draft items resulting in 39 items. The survey included demographic details, the draft Holistic Reflection Assessment Tool, emotional intelligence subscale, and a social desirability scale. Participants repeated the online survey at two weeks to confirm test-retest reliability.ResultsThe 187 responses were received. Exploratory factor analysis with varimax rotation revealed three factors accounting for 49% of variance. Internal consistency of the tool was high (α = .91) and test-retest reliability at two weeks (α = .93) demonstrated stability. There were low correlations between social desirability (r = .22, p < .001) and emotional intelligence (r = .21, p < .001) with the new holistic reflection scale.ConclusionsThe Holistic Reflection Assessment Tool is the first for midwifery. The tool was reliable, stable, and valid. Further research is warranted for criterion validity.     

Sexual Orientation and Sexual Health Care Needs: A Comparison of Women Beneficiaries in Outpatient Military Health Care Settings

ABSTRACT

The objectives of this study are to compare the sexual concerns, interest and experiences in discussing these concerns with their doctor for women of “Only Men” and “Some to Only Women” sexual orientation. A survey was mailed to women patients from two military outpatient settings, with 1,196 women responding. Of eligible respondents (N = 1,170), 90% reported “Only Men” and 10% reported “Some to Only Women” sexual orientation. Sexual concerns varied by sexual orientation, while interest and experience in discussing sexual concerns and desire for physicians to initiate the topic differed minimally. Women with “Some to Only Women” sexual orientation have both similar and differing sexual concerns compared to “male-only” oriented women. Larger primary care patient-based studies of sexual health care needs of sexual minorities are needed.     

Using Rasch analysis to identify midwifery students’ learning about providing breastfeeding support

AimTo report on a study measuring midwifery students’ self-reported abilities in teaching and supervising breastfeeding mothers. Abilities were assessed at two time intervals, before and after completing a maternal and infant nutrition topic with simultaneous clinical opportunities to consolidate their skills.MethodA convenience sample of midwifery students in an Australian university completed a pre- and post-intervention survey to assess their self-rated ability to teach and supervise breastfeeding mothers. Rasch analysis was used to gain conjoint estimates of students’ self-reported abilities to teach and supervise breastfeeding mothers across 37 items with varying complexity of care needs. Rasch analysis was used to determine validity and reliability of the 37-item tool, to develop a hierarchical linear scale reflecting difficulty of breastfeeding supportive activities, and to determine student learning between the two time points.ResultsFrom 95 responses, 34 of the 37 items met the requirement for unidimensionality. Outcomes identified that midwifery students’ self-efficacy measures for breastfeeding support abilities can be reliably estimated. A hierarchical scale for learning these clinical skills has been generated to inform curricula development and learning processes. While there was an overall increase in the ease of difficulty of 21 items in the survey at time point two, eight items were identified as becoming more difficult.ConclusionThe findings of this study challenge midwifery educators to reconsider the educational activities provided for midwifery students’ that aim to develop the requisite skills to provide effective breastfeeding support, including the provision of specific clinical opportunities to learn from breastfeeding women.     

Women's experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence

IssueFear of childbirth (FOC) can be debilitating, impacting women's lives in pregnancy, the puerperium and beyond. Research investigated various interventions for FOC in the perinatal period, but there been no synthesis of the experiences of women who engaged with these interventions, which would inform clinical practice guidance and the development of future interventions.AimTo conduct a review and synthesis of qualitative studies of interventions for fear of childbirth in the perinatal period and women's experiences of them.MethodsA meta-synthesis was performed to examine all relevant qualitative studies describing women's experiences of interventions for FOC, in all languages. A comprehensive search of relevant databases from 1978 to 2019 was conducted. In total, following appraisal, seven qualitative studies were eligible for inclusion. The findings were integrated using thematic synthesis for the final stages in the thematic analysis.FindingsOne overarching theme “Ownership of Childbirth” and three analytical themes “Facing the fear”, “Feeling empowered”, “Managing the fear with a sense of security” were generated through the synthesis. There were no studies outside of Scandinavia located.DiscussionThis meta-synthesis provides a new way to describe the process of moving from fear to “Ownership of childbirth”. The first step in the process appears to be acknowledging and identifying the individual's fears. Women can be empowered to self-manage FOC but may be influenced by external factors such as the support of partners and staff.ConclusionThese findings provide evidence to inform the development of future interventions for FOC and highlight the need for further qualitative research globally.