scholarly journals A psychometric evaluation of the Functional assessment of cancer therapy—kidney symptom index (FKSI-19) among renal cell carcinoma patients suggesting an alternative two-factor structure

2021 ◽  
Author(s):  
Andreas Karlsson Rosenblad ◽  
Pernilla Sundqvist ◽  
Bodil Westman ◽  
Börje Ljungberg
Keyword(s):  
Renal Cell Carcinoma ◽  
Factor Analysis ◽  
Cancer Therapy ◽  
Factor Structure ◽  
Functional Assessment ◽  
Renal Cell ◽  
Model Fit ◽  
Mean Square ◽  
Symptom Index ◽  
Acceptable Model

Abstract Purpose To psychometrically evaluate the hypothesized four-factor structure of the 19-item Functional Assessment of Cancer Therapy—Kidney Symptom Index (FKSI-19) health-related quality of life (HRQoL) instrument in a sample of surgically treated renal cell carcinoma (RCC) patients and examine if an alternative factor structure with good psychometric properties may be derived from the available items. Methods The model fit of the hypothesized four-factor structure was examined using confirmatory factor analysis on cohort data from 1731 individuals included in the National Swedish Kidney Cancer Register who had undergone surgery for RCC during the three years 2016–2018 and answered the FKSI-19 instrument within 6–12 months after surgery. Exploratory factor analysis was applied to the same dataset to derive a possible alternative factor solution. Results The four-factor structure did not reach the thresholds for good model fit using the normed χ2-value or the Comparative Fit Index, although the Standardized Root Mean Square Residual and Root Mean Square Error of Approximation measures indicated good and acceptable model fits, respectively. An alternative 14-item trimmed FKSI version (FKSI-14) with a two-factor structure derived from the available FKSI-19 items was found to measure the same aspects of HRQoL as the full FKSI-19 instrument. Conclusion The present study is the first to use psychometric methods for examining the factor structure of the FKSI-19 instrument. The hypothesized four-factor structure of FKSI-19 provided a barely acceptable model fit. The two-factor FKSI-14 structure may be used as an alternative or complement to the four-factor structure when interpreting the FKSI-19 instrument.

scholarly journals Validation and psychometric evaluation of the Dutch Person-centred care of Older People with cognitive impairment in Acute Care (POPAC)

2020 ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie Roodbol
Keyword(s):  
Factor Analysis ◽  
Acute Care ◽  
Model Fit ◽  
Mean Square ◽  
Person Centered Care ◽  
People With Dementia ◽  
Confirmatory Factor ◽  
Centered Care ◽  
Acceptable Model

Abstract Background People with dementia are regularly hospitalized. Person-centered care is the preferred model for caring for people with dementia. To improve the quality of care for people with dementia in an acute care setting, knowledge of the level of person-centeredness of the care is relevant. The POPAC is a tool to determine the level of Person-centred care. Translation enables international comparisons of data and outcomes of Person-centred care. This study aimed to translate and cross-nationally validate the Dutch Person-centred care of Older People with cognitive impairment in Acute Care scale and to evaluate its psychometric properties. Methods After translation, a total of 159 nurses recruited from six hospitals and via social media completed the POPAC. A confirmatory factor analysis was performed to test the factor-structure, and a Cronbach’s alpha scale was utilized to establish the reliability of the scale. Results A confirmatory factor analysis showed that the fit by the Confirmatory Fit Index was a nearly acceptable model fit. The Root Mean Square Error of Approximation and the Standardized Root Mean Square Residual suggested an acceptable model fit. The findings of the authors confirm a three-dimensional structure suggested by previous research. The loadings of the items indicate that these are strong associations with each of the factors. Besides, the factor correlations also indicate that these are strongly associated. These findings indicate that the factors are strongly associated with a general POPAC factor. This study confirms that, statistically, Item 5 could be deleted to improve the reliability of the instrument. Instead of deleting this item, the authors suggest considering rephrasing it into a positive item. Conclusions The Dutch version of the POPAC is sufficiently valid and reliable and can be utilized for assessing person-centered care in acute care hospitals. The study enables nurses to interpret and compare levels of Person-centred care in wards and hospital levels between regions and countries. The results form an important basis for improving the quality of care and nurse-sensitive outcomes such as prevention of complications and length of hospital stay.

Factorial Structure of the Therapist Adherence Measure-Revised (TAM-R) Within Multisystemic Therapy

2020 ◽  
Vol 36 (2) ◽  
pp. 427-431
Author(s):  
Aurelie M. C. Lange ◽  
Marc J. M. H. Delsing ◽  
Ron H. J. Scholte ◽  
Rachel E. A. van der Rijken
Keyword(s):  
Factor Analysis ◽  
Factor Structure ◽  
Factor Model ◽  
Multisystemic Therapy ◽  
Model Fit ◽  
Validity And Reliability ◽  
Adherence Measure ◽  
Therapist Adherence ◽  
Confirmatory Factor ◽  
The Us

Abstract. The Therapist Adherence Measure (TAM-R) is a central assessment within the quality-assurance system of Multisystemic Therapy (MST). Studies into the validity and reliability of the TAM in the US have found varying numbers of latent factors. The current study aimed to reexamine its factor structure using two independent samples of families participating in MST in the Netherlands. The factor structure was explored using an Exploratory Factor Analysis (EFA) in Sample 1 ( N = 580). This resulted in a two-factor solution. The factors were labeled “therapist adherence” and “client–therapist alliance.” Four cross-loading items were dropped. Reliability of the resulting factors was good. This two-factor model showed good model fit in a subsequent Confirmatory Factor Analysis (CFA) in Sample 2 ( N = 723). The current finding of an alliance component corroborates previous studies and fits with the focus of the MST treatment model on creating engagement.

scholarly journals Psychometric Properties of the 25-Item Connor-Davison Resilience Scale: Preliminary Data for a Romanian Military Population

2021 ◽  
Vol 26 (1) ◽  
pp. 31-38
Author(s):  
Iulia-Clarisa Giurcă ◽  
Adriana Baban ◽  
Sebastian Pintea ◽  
Bianca Macavei
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Construct Validity ◽  
Psychometric Properties ◽  
Factor Structure ◽  
Preliminary Data ◽  
Model Fit ◽  
Military Population ◽  
Resilience Scale ◽  
Confirmatory Factor

AbstractThe following study is aimed at investigating the construct validity of the 25-item Connor-Davidson Resilience Scale (CD-RISC 25) on a Romanian military population. The exploratory factor analysis was conducted on 434 male military participants, aged between 24 and 50 years (M = 34.83, S.D. = 6.14) and the confirmatory factor analysis was conducted on a sample of 679 military participants, of 605 men and 74 women, aged between 18 and 59 years (M = 38.37, S.D. = 9.07). Factor analysis of the scale showed it to be a bidimensional, rather than a multidimensional instrument, as the original five-factor structure was not replicated in this military Romanian sample. Moreover, EFAs suggested that a 14-item bidimensional model should be retained and CFA confirmed that this model fit the data best.

scholarly journals Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors

2019 ◽  
Vol 16 (21) ◽  
pp. 4157 ◽  
Author(s):  
Lichtveld ◽  
Covert ◽  
Sherman ◽  
Shankar ◽  
Wickliffe ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Health Literacy ◽  
Environmental Health ◽  
Factor Structure ◽  
Model Fit ◽  
Community Members ◽  
Attitudes And Behaviors ◽  
Environmental Health Literacy ◽  
And Behaviors ◽  
Three Factor

Environmental health literacy (EHL) involves understanding and using environmental information to make decisions about health. This study developed a validated survey instrument with four scales for assessing media-specific (i.e., air, food, water) and general EHL. The four scales were created as follows: 1) item generation: environmental health scientists and statisticians developed an initial set of items in three domains: knowledge, attitudes, and behaviors; 2) item review: items were reviewed for face validity; 3) validation: 174 public health students, the exploratory sample, and 98 community members, the test sample, validated the scales. The scales’ factor structure was based on exploratory factor analysis (EFA) and model fit was assessed through confirmatory factor analysis (CFA). For each scale, the final EFA resulted in an independent three-factor solution for knowledge, attitudes, and behaviors. Good fit for the three-factor structure was observed. Model fit for CFA was generally confirmed with fit indices. The scales showed internal consistency with Cronbach’s alpha from 0.63 to 0.70. The 42-item instrument represents an important contribution towards assessing EHL and is designed to enable meaningful engagement between researchers and community members about environmental health. The intended outcome is sustained community–academic partnerships benefiting research design, implementation, translation, dissemination, and community action.

scholarly journals Results of a Multicenter Phase II Study of Atezolizumab and Bevacizumab for Patients With Metastatic Renal Cell Carcinoma With Variant Histology and/or Sarcomatoid Features

2020 ◽  
Vol 38 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Bradley A. McGregor ◽  
Rana R. McKay ◽  
David A. Braun ◽  
Lillian Werner ◽  
Kathryn Gray ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Phase Ii ◽  
Renal Cell ◽  
Checkpoint Inhibitors ◽  
Progression Free Survival ◽  
Symptom Index ◽  
Multicenter Phase ◽  
Variant Histology ◽  
Sarcomatoid Differentiation

PURPOSE In this multicenter phase II trial, we evaluated atezolizumab combined with bevacizumab in patients with advanced renal cell carcinoma (RCC) with variant histology or any RCC histology with ≥ 20% sarcomatoid differentiation. PATIENTS AND METHODS Eligible patients may have received previous systemic therapy, excluding prior bevacizumab or checkpoint inhibitors. Patients underwent a baseline biopsy and received atezolizumab 1,200 mg and bevacizumab 15 mg/kg intravenously every 3 weeks. The primary end point was overall response rate (ORR) by RECIST version 1.1. Additional end points were progression-free survival (PFS), toxicity, biomarkers of response as determined by programmed death-ligand 1 (PD-L1) status, and on-therapy quality-of-life (QOL) metrics using the Functional Assessment of Cancer Therapy Kidney Symptom Index-19 and the Brief Fatigue Inventory. RESULTS Sixty patients received at least 1 dose of either study agent; the majority (65%) were treatment naïve. The ORR for the overall population was 33% and 50% in patients with clear cell RCC with sarcomatoid differentiation and 26% in patients with variant histology RCC. Median PFS was 8.3 months (95% CI, 5.7 to 10.9 months). PD-L1 status was available for 36 patients; 15 (42%) had ≥ 1% expression on tumor cells. ORR in PD-L1–positive patients was 60% (n = 9) v 19% (n = 4) in PD-L1–negative patients. Eight patients (13%) developed treatment-related grade 3 toxicities. There were no treatment-related grade 4-5 toxicities. QOL was maintained throughout therapy. CONCLUSION In this study, atezolizumab and bevacizumab demonstrated safety and resulted in objective responses in patients with variant histology RCC or RCC with ≥ 20% sarcomatoid differentiation. This regimen warrants additional exploration in patients with rare RCC, particularly those with PD-L1–positive tumors.

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