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Background: Adverse drug reactions (ADRs), particularly in the context of polypharmacy, remain a persistent, unresolved problem for patients and healthcare professionals. The ADRe Profile identifies medicine‐related harms, and supports their resolution, thereby improving care quality and preventing future problems. Objective: The objective of this study was to assess the validity and reliability of the ADRe Profile ( https://www.swansea.ac.uk/adre/ ) in U.K. primary care general practices, building on assessments in other settings. Methods: The ADRe Profile’s validity and reliability were investigated using complementary mixed methods: content validity index, contrast group construct validity, cognitive interviewing, and inter‐rater reliability. Results: Cognitive interviews ( n = 5) confirmed that the ADRe Profile needed only minor adjustments. The scale‐level content validity index was 0.67 ( n = 14), items ranging from 0.08 to 1. Significant differences in signs and symptoms associated with ADRs between service users taking different numbers of regular prescribed medicines confirmed construct validity ( n = 68, U = 870.50, p < 0.001). Inter‐rater reliability testing showed substantial agreement between service users and research nurse: 10 items had 100% agreement. Overall kappa mean was 0.71 (range: 0.31–1), ( n = 42). Conclusions and Relevance: The ADRe Profile is suitable for use with older service users in primary care who live at home. Users understood the questions and provided meaningful answers. ADRe Profile responses were sufficiently reliable to be used as a basis for further investigations, prescriber referral and clinical actions. However, clinician judgement of content validity may depend on knowledge and experience, highlighting the importance of training. Clinicians acknowledged that the ADRe Profile was comprehensive but identified practical difficulties. Instruments to reduce ADRs should be validated before testing in feasibility studies and randomised controlled trials. Implications for Nursing Management: Managers need to optimise patient safety by introducing patient‐centred symptom monitoring, with decision support. Before instruments are adopted, managers should check the reliability and validity data. Trial Registration: ClinicalTrials.gov identifier: NCT04663360

Purpose Head-to-head comparison of reliability, validity and responsiveness of four patient-reported outcome measures (PROMS) suitable for assessing health-related quality of life (HRQOL) in palliative care settings: EORTC QLQ-C15-PAL, FACT-G7, FACIT-Pal and short-form FACIT-Pal-14. Methods Secondary analysis of two phase III randomised trials: ketamine for chronic cancer pain, octreotide for vomiting in inoperable malignant bowel obstruction. Sub-groups were defined by Australia-modified Karnofsky performance status (AKPS) and participants’ global impression of change (GIC). Two aspects of reliability were assessed: internal consistency (Cronbach alpha, α ); test–retest reliability (intra-class correlation coefficient (ICC)) of patients with stable AKPS and those who self-reported ‘no change’ on GIC. Construct validity was assessed via pre-determined hypotheses about sensitivity of PROM scores to AKPS groups and responsiveness of PROM change scores to GIC groups using analysis of variance. Results FACIT-Pal had better internal consistency ( α ranged 0.59–0.80, 15/18 ≥ 0.70) than QLQ-C15-PAL (0.51–0.85, 4/8 ≥ 0.70) and FACT-G7 (0.54–0.64, 0/2 ≥ 0.70). FACIT scales had better test–retest reliability (FACIT-Pal 11/27 ICCs ≥ 0.70, FACT-G7 2/3 ICCs ≥ 0.70) than QLQ-C15-PAL (2/30 ICCs ≥ 0.70, 18/30 ≤ 0.5). Four scales demonstrated sensitivity to AKPS: QLQ-PAL-15 Physical Functioning and Global QOL, FACT-G Functional Wellbeing and FACIT-Pal Trial Outcome Index (TOI). Nine scales demonstrated responsiveness: three in the ketamine trial population (QLQ-C15-PAL Pain, FACIT-Pal-14, FACT-G7), six in the octreotide trial population (QLQ-C15-PAL Fatigue; FACIT-Pal PalCare, TOI, Total; FACT-G Physical Wellbeing and Total). Conclusions No PROM was clearly superior, confirming that choosing the best PROM requires careful consideration of the research goals, patient population and the domains of HRQOL targeted by the intervention being investigated.

Aim To validate a modified version of the Intrinsic Motivation Inventory (IMI)—the IMI‐HeartLife—adapted for heart‐healthy lifestyle behaviours in community‐dwelling adults without a history of cardiovascular disease. While the original IMI has been validated in contexts such as competitive sports and education, its use in healthcare—particularly for cardiovascular disease prevention—has been limited. Design A validation study addressing content and construct validity and reliability. Methods The IMI‐HeartLife was refined through three phases: (1) conceptualisation and item pool generation, (2) evaluation of content and face validity and (3) psychometric evaluation. As part of the psychometric evaluation, two established instruments were employed to assess the discriminant and convergent validity of the IMI‐HeartLife scale. Results A total of 703 community‐dwelling adults were recruited and randomly assigned to two subsamples for exploratory (n = 352) and confirmatory (n = 351) factor analyses. From the initial 32 items drawn from five original IMI subscales, 16 were retained. A three‐factor structure—Interest/Enjoyment, Choice/Value/Usefulness and Competence/Effort—was supported (CMIN/DF = 3.43, SRMR = 0.06, RMSEA = 0.08, CFI = 0.95, TLI = 0.94). Discriminant and convergent validity of the IMI‐HeartLife were confirmed, and internal consistency and test–retest reliability were acceptable. Conclusions The 16‐item IMI‐HeartLife demonstrated good validity and reliability as a measure of intrinsic motivation to promote heart‐healthy lifestyle in cardiovascular disease prevention. Implications for the Profession In community and primary care settings, nurses are well positioned to assess intrinsic motivation as a core cognitive construct and to deliver personalised interventions that promote heart‐healthy lifestyle behaviours in the context of cardiovascular disease prevention. Within this framework, the IMI‐HeartLife may serve as a valuable instrument for assessing intrinsic motivation and guiding individualised nursing strategies. Reporting Method COSMIN reporting guideline for studies on measurement properties of patient‐reported outcome measures (PROM): version 2.0. Public Engagement The content analysis was conducted in collaboration with an interdisciplinary user group including eight healthcare professionals.

Even though classic job design theories have evolved over the years and become more focused on employees' ability to autonomously change their job characteristics, tools to assess job crafting are still limited. The purpose of this study was to analyze the psychometric properties of the Spanish version of the Job Crafting Questionnaire (JCQ), taking into account the valuable contribution made by Wrzesniewski and Dutton's model to the understanding of the job crafting concept. The total sample consisted of 768 employees (participants' mean age was 41.63 and 49.7% of them were women). The sample was randomly divided into two halves in order to conduct two factor analyses (Exploratory Factor Analysis and Confirmatory Factor Analysis). Concurrent and convergent validity was assessed by computing correlations with validated questionnaires for measuring job crafting (Job Crafting Scale, JCS), engagement (Utrecht Work Engagement Scale, UWES-9) and job burnout (Maslach Burnout Inventory-General Survey, MBI-GS). The results indicated a high level of internal consistency (Cronbach's alpha = .880) which was similar to the original scale, and provided a good fit to the three-dimensional model tested. Appropriate evidence of construct validity was also shown (r = .45 with total JCS; r = .52 with total UWES-9 and r-values between -.33 and .45 with MBI dimensions). The results confirmed that the Spanish translation of the JCQ is a suitable tool for measuring job crafting and enabling practitioners and researchers to further expand the existing knowledge of this concept.

Compare the efficacy of two interventions addressing emotional and existential well-being in early life-limiting illness. Primary trial analysis (n = 135) included patients with advanced cancer, congestive heart failure, or end-stage renal disease; Arm 1 received the Outlook intervention, addressing issues of life completion and preparation, and Arm 2 received relaxation meditation (RM). Primary outcomes at five weeks (primary endpoint) and seven weeks (secondary): completion and preparation (QUAL-E); secondary outcomes: anxiety (POMS) quality of life (FACT-G) and spiritual well-being (FACIT-Sp) subscales of faith, meaning, and peace. Average age was 62; 56% were post-high school-educated, 54% were married, 52% white, 44% female, and 70% had a cancer diagnosis. At baseline, participants demonstrated low levels of anxiety (<5 on POMS subscale) and depression (<10 on CESD) relative to population norms. Results of the primary analysis revealed no significant differences in mean Preparation by treatment arm at five weeks (14.4 Outlook vs. 14.8 RM; between-group difference -0.4 [95% CI, -1.6, 0.8], p = 0.49) or seven weeks (15.2 vs.15.4; between-group difference -0.2 [95% CI, -1.5, 1.0], p = 0.73). There were also no significant differences in mean Life Completion by treatment arm between five weeks (26.6 Outlook vs. 26.3 RM; between-group difference 0.2 [95% CI, -1.2, 1.7], p = 0.76) or seven weeks (26.5 vs. 27.5; between-group difference -1.0 [95% CI, -2.7, 0.7], p = 0.23). Compared to RM, Outlook participants did not have significant differences over time in the secondary outcomes of overall quality of life, anxiety, depression, FACT-G subscales, and FACIT-Sp subscales. In early-stage life-limiting illness, Outlook did not demonstrate a significant difference in primary or secondary outcomes relative to RM. Results underscore the importance of pre-screening for distress. Qualitatively, Outlook participants were able to express suppressed emotions, place illness context, reflect on adaptations, and strengthen identity. Screening for distress and identifying specified measures of distress, beyond anxiety and depression, is essential in our ability to adequately assess the multi-dimensional mechanisms that decrease existential suffering.

Background A high quality decision requires that patients who meet clinical criteria for surgery are informed about the options (including non-surgical alternatives) and receive treatments that match their goals. The aim of this study was to evaluate the psychometric properties and clinical sensibility of a patient self report instrument, to measure the quality of decisions about total joint replacement for knee or hip osteoarthritis. Methods The performance of the Hip/Knee Osteoarthritis Decision Quality Instrument (HK-DQI) was evaluated in two samples: (1) a cross-sectional mail survey with 489 patients and 77 providers (study 1); and (2) a randomized controlled trial of a patient decision aid with 138 osteoarthritis patients considering total joint replacement (study 2). The HK-DQI results in two scores. Knowledge items are summed to create a total knowledge score, and a set of goals and concerns are used in a logistic regression model to develop a concordance score. The concordance score measures the proportion of patients whose treatment matched their goals. Hypotheses related to acceptability, feasibility, reliability and validity of the knowledge and concordance scores were examined. Results In study 1, the HK-DQI was completed by 382 patients (79%) and 45 providers (58%), and in study 2 by 127 patients (92%), with low rates of missing data. The DQI-knowledge score was reproducible (ICC = 0.81) and demonstrated discriminant validity (68% decision aid vs. 54% control, and 78% providers vs. 61% patients) and content validity. The concordance score demonstrated predictive validity, as patients whose treatments were concordant with their goals had more confidence and less regret with their decision compared to those who did not. Conclusions The HK-DQI is feasible and acceptable to patients. It can be used to assess whether patients with osteoarthritis are making informed decisions about surgery that are concordant with their goals.

Since the inclusion of the Internet Gaming Disorder (IGD) in the Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), a short nine items test, has become one of the most used standardized instruments for its psychometric evaluation. This study presents a validation and psychometric evaluation of the Spanish version of the IGDS9-SF. A sample of 2173 videogame players between 12 and 22 years old, comprising both genders, was employed, achieved with a randomized selection process from educational institutions in the city of Madrid. Participants completed the adapted version of the IGDS9-SF, the General Health Questionnaire (GHQ-12) and a negative cognitions scale associated with videogame use, as well as sociodemographic data and frequency of videogame play. A unifactorial structure with sufficient reliability and internal consistency was found through exploratory and confirmatory analyses. In addition, the instrument was found to have good construct validity; the scoring of the IGDS9-SF were found to show a positive association with gaming frequency, with general health problems, and to a greater extent, with problematic cognitions with regard to videogames. Factorial invariance was found concerning the age of participants. However, even though the factorial structure was consistent across genders, neither metric nor scalar invariance were found; for this reason, we present a scale for the whole sample and a different one for gender. These results suggest that this Spanish version of the IGDS9-SF is a reliable and valid instrument, useful to evaluate the severity of IGD in Spanish students, and we provide a scoring scale for measurement purposes.

Background Fear of falling (FOF) is commonly experienced in people with Parkinson’s disease (PD). It is a predictor of recurrent falls, a barrier to physical exercise, and negatively associated with health-related quality of life. A variety of rating scales exist that assess different aspects of FOF but comprehensive head-to-head comparisons of their psychometric properties in people with PD are lacking. The aim of this study was to evaluate the psychometric properties of four FOF rating scales in people with PD. More specifically, we investigated and compared the scales’ data completeness, scaling assumptions, targeting, and reliability. Methods The FOF rating scales were: the Falls Efficacy Scale-International (FES-I), the Swedish FES (FES(S)), the Activities-specific Balance Confidence scale (ABC), and the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE). A postal survey was administered to 174 persons with PD. Responders received a second survey after two weeks. Results The mean (SD) age and PD duration of the 102 responders were 73 (8) and 7 (6) years, respectively. ABC had worse data completeness than the other scales (6.9 vs. 0.9–1.3% missing data). All scales had corrected item-total correlations exceeding 0.4 and showed acceptable reliabilities (Cronbach’s alpha and Intraclass Correlation Coefficient (ICC) >0.80) but only FES-I had ICC >0.90. The standard error of measurements ranged from 7% (FES-I) to 12% (FES(S)), and the smallest detectable differences ranged from 20% (FES-I) to 33% (FES(S)) of the total score ranges. ABC and FES(S) had substantially more outliers than mSAFFE and FES-I (10 and 15 vs. 3 and 4, respectively) when the two test occasions were compared. Conclusions When assessing FOF in people with PD, the findings in the present study favoured the choice of FES-I or mSAFFE. However, FES-I was the only scale with ICC >0.90 which has been suggested as a minimum when using a scale for individual comparisons.

Background Health-promoting lifestyle choices of adolescents are closely related to current and subsequent health status. However, parsimonious yet reliable and valid screening tools are scarce. The original 40-item adolescent health promotion (AHP) scale was developed by our research team and has been applied to measure adolescent health-promoting behaviors worldwide. The aim of our study was to examine the psychometric properties of a newly developed short-form version of the AHP (AHP-SF) including tests of its reliability and validity. Methods The study was conducted in nine middle and high schools in southern Taiwan. Participants were 814 adolescents randomly divided into two subgroups with equal size and homogeneity of baseline characteristics. The first subsample (calibration sample) was used to modify and shorten the factorial model while the second subsample (validation sample) was utilized to validate the result obtained from the first one. The psychometric testing of the AHP-SF included internal reliability of McDonald’s omega and Cronbach's alpha, convergent validity, discriminant validity, and construct validity with confirmatory factor analysis (CFA). Results The results of the CFA supported a six-factor model and 21 items were retained in the AHP-SF with acceptable model fit. For the discriminant validity test, results indicated that adolescents with lower AHP-SF scores were more likely to be overweight or obese, skip breakfast, and spend more time watching TV and playing computer games. The AHP-SF also showed excellent internal consistency with a McDonald’s omega of 0.904 (Cronbach’s alpha 0.905) in the calibration group. Conclusion The current findings suggest that the AHP-SF is a valid and reliable instrument for the evaluation of adolescent health-promoting behaviors. Primary health care providers and clinicians can use the AHP-SF to assess these behaviors and evaluate the outcome of health promotion programs in the adolescent population.

Background A variety of instruments are used to measure health related quality of life. Few data exist on the performance and agreement of different instruments in a depressed population. The aim of this study was to investigate agreement between, and suitability of, the EQ-5D-3L, EQ-5D Visual Analogue Scale (EQ-5D VAS), SF-6D and SF-12 new algorithm for measuring health utility in depressed patients. Methods The intraclass correlation coefficient (ICC) and Bland and Altman approaches were used to assess agreement. Instrument sensitivity was analysed by: (1) plotting utility scores for the instruments against one another; (2) correlating utility scores and depressive symptoms (Beck Depression Inventory (BDI)); and (3) using Tukey’s procedure. Receiver Operating Characteristic (ROC) analysis assessed instrument responsiveness to change. Acceptability was assessed by comparing instrument completion rates. Results The overall ICC was 0.57. Bland and Altman plots showed wide limits of agreement for each pair wise comparison, except between the SF-6D and SF-12 new algorithm. Plots of utility scores displayed ’ceiling effects’ in the EQ-5D-3L index and ’floor effects’ in the SF-6D and SF-12 new algorithm. All instruments showed a negative monotonic relationship with BDI, but the EQ-5D-3L index and EQ-5D VAS could not differentiate between depression severity sub-groups. The SF-based instruments were better able to detect changes in health state over time. There was no difference in completion rates of the four instruments. Conclusions There was a lack of agreement between utility scores generated by the different instruments. According to the criteria of sensitivity, responsiveness and acceptability that we applied, the SF-6D and SF-12 may be more suitable for the measurement of health related utility in a depressed population than the EQ-5D-3L, which is the instrument currently recommended by NICE.