Newcastle satisfaction with nursing scales: an instrument for quality assessments of nursing care.
(9/6813)
OBJECTIVES: To test the validity and reliability of scales for measuring patients' experiences of and satisfaction with nursing care; to test the ability of the scales to detect differences between hospitals and wards; and to investigate whether place of completion, hospital, or home influences response. DESIGN: Sample survey. SETTING: 20 wards in five hospitals in the north east of England. PATIENTS: 2078 patients in general medical and surgical wards. MAIN MEASURES: Experiences of and satisfaction with nursing care. RESULTS: 75% of patients approached to complete the questionnaires did so. Construct validity and internal consistency were both satisfactory. Both the experience and satisfaction scales were found to detect differences between randomly selected wards and hospitals. A sample of patients (102) were sent a further questionnaire to complete at home. 73% returned this; no significant differences were found in either experience or satisfaction scores between questionnaires given in hospital or at home. CONCLUSION: Scales to measure patients' experiences of and satisfaction with nursing in acute care have been developed and found to be valid, reliable, and able to detect differences between hospitals and wards. Questionnaires can be given before patients leave hospital or at home without affecting scores, but those given at home have a lower response rate. (+info)
Indicators of the quality of general practice care of patients with chronic illness: a step towards the real involvement of patients in the assessment of the quality of care.
(10/6813)
OBJECTIVE: To develop a list of indicators of the general practice care of people with chronic illnesses considered important by both patients and practitioners and to identify the indicators that are considered relevant for patient assessment of health care quality. DESIGN: Qualitative study with focus group interviews and a written consensus procedure. SETTING: General practice in the Netherlands in 1993. SUBJECTS: 34 patients with chronic illness, mostly members of patient organisations, and 19 general practitioners with expertise in either chronic disease management or experience with patient surveys. MAIN MEASURES: Aspects of general practice care considered important for the delivery of good quality care that emerged from focus group interviews; the relevance of evaluations of 41 aspects of care for patients explored through the written consensus procedure. Those aspects of general practice care agreed to be both important and relevant by patients and general practitioners were considered to be suitable indicators for patient assessment of the quality of care. RESULTS: Patients and general practitioners differed to some extent in their assessment of the aspects of care that they considered important for quality. They agreed that most indicators of care that related to the inverted question markdoctor-patient relation inverted question mark and to inverted question markinformation and support inverted question mark were relevant and therefore suitable as indicators for patient assessment of health care quality. There was less agreement about the relevance of indicators of inverted question markmedical and technical care, inverted question mark inverted question markavailability and accessibility, inverted question mark and inverted question markorganisation of services. inverted question mark CONCLUSIONS: Several indicators of the quality of general practice care of patients with chronic illness were thought to be suitable for the patient assessment of healthcare quality, but other indicators were not, mainly because of reservations by general practitioners. IMPLICATIONS: Qualitative methods can contribute to the selection of indicators for assessment of the quality of health care in areas where scientific evidence is limited or where patients' and providers' preferences are particularly important. (+info)
Measuring intermediate outcomes of violence prevention programs targeting African-American male youth: an exploratory assessment of the psychometric properties of six psychosocial measures.
(11/6813)
This study examined the psychometric properties of six psychosocial measures that may be useful indicators of intermediate outcomes of violence prevention programs targeting African-American male youth. Baseline and 6 month follow-up survey data are used from 223 African-American male 12-16 year olds participating in a violence prevention program evaluation study. The constructs of interest are beliefs supporting aggression, aggressive conflict-resolution style, hostility, ethnic identity, self-esteem and hopelessness. Each construct is measured as a multi-item scale. Exploratory factor analysis results provided limited support for the unidimensionality of these scales, thus suggesting that further scale development is warranted. Reliability coefficients for the scales ranged from 0.55 to 0.80. Bivariate analyses with baseline data indicate that all six measures have construct and criterion-related validity, as they are associated with each other and with four behavioral criteria in the expected directions. Predictive validity was also demonstrated for beliefs supporting aggression, aggressive conflict-resolution style, hostility and hopelessness which were associated with weapon-carrying behaviors measured in the 6 month follow-up survey both before and after controlling for corresponding behaviors measured in the baseline survey. (+info)
Measuring attitudes towards smoking in the Community Intervention Trial for Smoking Cessation (COMMIT).
(12/6813)
We present the development of indices using baseline data from the Evaluation Survey for the Community Intervention Trial for Smoking Cessation (COMMIT). The indices are designed to measure two primary attitude constructs that relate to smoking behavior: beliefs about smoking as a public health problem (SPHP); and norms and values concerning smoking (NVS). Two general approaches to index construction, the rational method and the factor analytic method, were used. Item analysis suggested good internal consistency for both indices (alpha > 0.75). Seven subconstructs emerged from the factor analysis accounting for 55.0% of the total variance. The SPHP and NVS items uniquely identify with four factors and three factors, respectively, confirming the validity of the two indices. Confirmatory factor analyses of a different data set provided further validation. Validity was also assessed by an examination of the relationships between index scores and smoking status. Smokers reported significantly higher scores than non-smokers on the two measures indicating, as anticipated, that smokers have more favorable attitudes towards smoking than non-smokers. These findings suggest that the two a priori constructs of SPHP and NVS are empirically distinguishable components of attitudes towards smoking, and that the indices developed here are reliable and valid measures of those constructs. (+info)
Assessing the reliability of a stage of change scale.
(13/6813)
The purpose of this study was to assess the test-retest reliability of a scale measuring Prochaska's stages of change. Although structured questionnaire items are being increasingly used to segment target audiences according to Prochaska and DiClemente's stages of change, we could find only one report in the literature assessing the reliability of such scales. The unreliability of single-item or algorithm questionnaire scales might be why a number of studies show only minimal differences on some variables between individuals in different stages of change. A survey of the Perth metropolitan general population aged 16-69 years (N = 2629) was completed in August-September 1992 as part of a 3 year evaluation of the Western Australian Health Promotion Foundation. The consistency of respondents' responses was assessed across two questions measuring stages of change for the behaviours quitting smoking (n = 404), reducing alcohol consumption (n = 57) and doing more exercise (n = 704). Given the immediacy of the test-retest situation, the reliability results are moderately encouraging: kappa = 0.72, 0.73 and 0.52 for quitting smoking, reducing alcohol and doing more exercise, respectively. Health researchers should be aware of the probable moderate level of reliability if using the type of scale assessed in this study, when interpreting differences between individuals in different stages. In practice, several questionnaire items for classification purposes should be used so that internal reliability measures can be calculated. It is recommended that research be undertaken to devise more reliable scales for stages of change for the various health behaviours. It is noted that the attitude literature with respect to context and time specific intentions could be helpful in devising such scales. (+info)
5-HT modulation of dopamine release in basal ganglia in psilocybin-induced psychosis in man--a PET study with [11C]raclopride.
(14/6813)
The modulating effects of serotonin on dopamine neurotransmission are not well understood, particularly in acute psychotic states. Positron emission tomography was used to examine the effect of psilocybin on the in vivo binding of [11C]raclopride to D2-dopamine receptors in the striatum in healthy volunteers after placebo and a psychotomimetic dose of psilocybin (n = 7). Psilocybin is a potent indoleamine hallucinogen and a mixed 5-HT2A and 5-HT1A receptor agonist. Psilocybin administration (0.25 mg/kg p.o.) produced changes in mood, disturbances in thinking, illusions, elementary and complex visual hallucinations and impaired ego-functioning. Psilocybin significantly decreased [11C]raclopride receptor binding potential (BP) bilaterally in the caudate nucleus (19%) and putamen (20%) consistent with an increase in endogenous dopamine. Changes in [11C]raclopride BP in the ventral striatum correlated with depersonalization associated with euphoria. Together with previous reports of 5-HT receptor involvement in striatal dopamine release, it is concluded that stimulation of both 5-HT2A and 5-HT1A receptors may be important for the modulation of striatal dopamine release in acute psychoses. The present results indirectly support the hypothesis of a serotonin-dopamine dysbalance in schizophrenia and suggest that psilocybin is a valuable tool in the analysis of serotonin-dopamine interactions in acute psychotic states. (+info)
Correlating fibreoptic nasotracheal endoscopy performance and psychomotor aptitude.
(15/6813)
We have investigated the correlation between the scores attained on computerized psychometric tests, measuring psychomotor and information processing aptitudes, and learning fibreoptic endoscopy with the videoendoscope. Sixteen anaesthetic trainees performed two adaptive tracking tasks (ADTRACK 2 and ADTRACK 3) and one information management task (MAZE) from the MICROPAT testing system. They then embarked on a standardized fibreoptic training programme during which they performed 15 supervised fibreoptic nasotracheal intubations on anaesthetized oral surgery patients. There was a significant correlation between the means of the 15 endoscopy times and both ADTRACK 2 (r = -0.599, P = 0.014) and ADTRACK 3 (r = -0.589, P = 0.016) scores. The correlation between the means of the 15 endoscopy times and MAZE scores was not significant. The ratios of the mean endoscopy time for the last seven endoscopies to the mean endoscopy time for the first seven endoscopies were not significantly correlated with ADTRACK 2, ADTRACK 3 or MAZE scores. Psychomotor abilities appeared to be determinants of trainees' initial proficiency in endoscopy, but did not appear to be determinants of trainees' rates of progress during early fibreoptic training. (+info)
Physical activity assessment in population surveys: can it really be simplified?
(16/6813)
BACKGROUND: Several studies have used a simplified approach for the assessment of physical activity such as the frequency of exercise-induced sweating. In this study leisure-time physical activity has been assessed using this and another more detailed measure. SUBJECTS AND METHODS: A sample of 4171 adults answered the Health Interview Survey of Barcelona in 1992. The respondents were classified into categories depending on participation in moderate and/or intense physical activity (> or =20 min) and also according to the frequency of exercise-induced sweating: 0, 1-2 and > or =3 times/week. Agreement between the two measures was calculated using the weighted Kappa (Kw) statistic with 95% confidence intervals (95% CI). Stratified analyses were performed. RESULTS: Prevalence of physical activity > or =3 times/week was lower with the sweat question (12.5%) than with the questions about the frequency of performance of selected activities (19.6%). The physical activity patterns by age, gender and overweight were similar for the two measures, but differed by month of the year. Agreement was lower among the older age categories and was higher among males (Kw = 0.59, 95% CI: 0.57-0.62) than among females (Kw = 0.48, 95% CI: 0.46-0.50). Overall, the agreement was higher in the hotter months (Kw = 0.72 among males and 0.58 among females). CONCLUSIONS: In the assessment of physical activity in the population by means of the sweat question there can be interference from other variables, apart from the intensity of the activity, which influence sweating during the exercise. Further assessments of the validity of exercise-induced sweating in representative samples of the general population would be useful. (+info)