Examination of validity, reliability, and interpretability of a self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) – A Rasch analysis

Objectives Informal caregivers often experience a restriction in occupational balance. The self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) is a measurement instrument to assess occupational balance in informal caregivers. Measurement properties of the German version of the OBI-Care had previously been assessed in parents of preterm infants exclusively. Thus, the aim of this study was to examine the measurement properties of the questionnaire in a mixed population of informal caregivers. Methods A psychometric study was conducted, applying a multicenter cross-sectional design. Measurement properties (construct validity, internal consistency, and interpretability) of each subscale of the German version of the OBI-Care were examined. Construct validity was explored by assessing dimensionality, item fit and overall fit to the Rasch model, and threshold ordering. Internal consistency was examined with inter-item correlations, item-total correlations, Cronbach’s alpha, and person separation index. Interpretability was assessed by inspecting floor and ceiling effects. Results A total of 196 informal caregivers, 171 (87.2%) female and 25 (12.8%) male participated in this study. Mean age of participants was 52.27 (±12.6) years. Subscale 1 was multidimensional, subscale 2 and subscale 3 were unidimensional. All items demonstrated item fit and overall fit to the Rasch model and displayed ordered thresholds. Cronbach’s Alpha and person separation index values were excellent for each subscale. There was no evidence of ceiling or floor effects. Conclusions We identified satisfying construct validity, internal consistency, and interpretability. Thus, the findings of this study support the application of the German version of the OBI-Care to assess occupational balance in informal caregivers.

Tropical Forests Classification Based on Weighted Separation Index from Multi-Temporal Sentinel-2 Images in Hainan Island

Tropical forests play a vital role in biodiversity conservation and the maintenance of sustainability. Although different time-series spatial resolution satellite images have provided opportunities for tropical forests classification, the complexity and diversity of vegetation types still pose challenges, especially for distinguishing different vegetation types. In this paper, we proposed a Spectro-Temporal Feature Selection (STFS) method based on the Weighted Separation Index (WSI) using multi-temporal Sentinel-2 data for mapping tropical forests in Jianfengling area, Hainan Province. The results showed that the tropical forests were classified with an overall accuracy of 93% and an F1 measure of 0.92 with multi-temporal Sentinel-2 data. As our results also revealed, the WSI based STFS method could be efficient in tropical forests classification by using a fewer feature subset compared with Variable Selection Using Random Forest (14 features and all 40 features, respectively) to achieve the same accuracy. The analysis also showed it was not advisable to only pursue a higher WSI value while ignoring the heterogeneity and diversity of features. This study demonstrated that the WSI can provide a new feature selection method for multi-temporal remote sensing image classification.

Reliability and Validity of the Patient Activation Measure in Kidney Disease: Results of Rasch Analysis

Background and objectivesDespite the increasing prioritization of the promotion of patient activation in nephrology, its applicability to people with CKD is not well established. Before the Patient Activation Measure is universally adopted for use in CKD, it is important to critically evaluate this measure. The aim of this study was to describe the psychometric properties of the Patient Activation Measure in CKD.Design, setting, participants, & measurementsA survey containing the 13-item Patient Activation Measure was completed by 942 patients with CKD, not treated with dialysis. Data quality was assessed by mean, item response, missing values, floor and ceiling effects, internal consistency (Cronbach’s alpha and average interitem correlation), and item-rest correlations. Rasch modeling was used to assess item performance and scaling (item statistics, person and item reliability, rating scale diagnostics, factorial test of residuals, and differential item functioning).ResultsThe item response was high, with a small number of missing values (<1%). Floor effect was small (range 1%–5%), but the ceiling effect was above 15% for nine items (range 15%–38%). The Patient Activation Measure demonstrated good internal consistency overall (Cronbach α=0.925, and average interitem correlation 0.502). The difficulty of the Patient Activation Measure items ranged from −0.90 to 0.86. Differential item functioning was found for disease type (item 3) and age (item 12). The person separation index was 9.48 and item separation index was 3.21.ConclusionsThe 13-item Patient Activation Measure appears to be a suitably reliable and valid instrument for assessing patient activation in CKD. In the absence of a kidney-specific instrument, our results support the 13-item Patient Activation Measure as a promising measure to assess activation in those with CKD, although consideration for several items is warranted. The high ceiling effect may be a problem when using the 13-item Patient Activation Measure to measure changes over time.

The Holistic Coronary Physiology Display: Calculation of the Flow Separation Index in Vessel-Specific Individual Flow Range during Fractional Flow Reserve Measurement Using 3D Coronary Reconstruction

In order to make optimal decisions on the treatment of atherosclerotic coronary heart disease (CHD), appropriate evaluation is necessary, including both the anatomical and physiological assessment of the coronary arteries. According to current guidelines, a fractional flow reserve (FFR)–based clinical decision is recommended, but coronary flow reserve (CFR) measurements and microvascular evaluation should also be considered in special cases for a detailed exploration of the coronary disease state. We aimed to generate an extended physiological evaluation during routine FFR measurement and define a new pathological flow–related prognostic factor. Fluid dynamic equations were applied to calculate CFR on the basis of the three-dimensional (3D) reconstruction of the invasively acquired coronary angiogram and the measured intracoronary pressure data. A new, potentially robust prognostic parameter of a coronary lesion called the “flow separation index” (FSi), which is thought to detect the pathological flow amount through a stenosis was introduced in a vessel-specific flow range. Correlations between FSi and the clinically established physiological indices (CFR and FFR) were determined. The FSi was calculated in 19 vessels of 16 patients, including data from the pre- and post-stent revascularization treatment of 3 patients. There was no significant correlation between the FSi and the CFR (r = −0.23, p = 0.34); however, there was significant negative correlation between the FSi and the FFR (r = −0.66, p = 0.002). An even stronger correlation was found between the FSi and the ratio of the resting pressure ratio and the FFR (r = 0.92, p < 0.0001). The diagnostic power of the FSi for predicting the FFR value of <0.80, as a gold standard prognostic factor, was tested by receiver operating characteristic analysis. FSi > 0.022 proved to be the cutoff value of the prediction of a pathologically low FFR with a 0.856 area under the curve (95% confidence interval: 0.620 to 0.972). The present flow–pressure–velocity display provides a comprehensive summary of patient-specific pathophysiology in CHD. The consequences of epicardial stenoses can be evaluated together with their complex relations to microvascular conditions. Based on these values, clinical decision-making concerning both pharmacological therapy and percutaneous or surgical revascularization may be more precisely guided.

Separation of convective and stratiform precipitation using polarimetric radar data with a support vector machine method

A precipitation separation approach using a support vector machine method was developed and tested on a C-band polarimetric weather radar located in Taiwan (RCMK). Different from those methods requiring whole-volume scan data, the proposed approach utilizes polarimetric radar data from the lowest unblocked tilt to classify precipitation echoes into either stratiform or convective types. In this algorithm, inputs of radar reflectivity, differential reflectivity, and the separation index are integrated through a support vector machine. The weight vector and bias in the support vector machine were optimized using well-classified data from two precipitation events. The proposed approach was tested with three precipitation events, including a widespread mixed stratiform and convective event, a tropical typhoon precipitation event, and a stratiform-precipitation event. Results from the multi-radar–multi-sensor (MRMS) precipitation classification algorithm were used as the ground truth in the performance evaluation. The performance of the proposed approach was also compared with the approach using the separation index only. It was found that the proposed method can accurately classify the convective and stratiform precipitation and produce better results than the approach using the separation index only.

Validation of the Brazilian Portuguese version of Evidence-based Practice Knowledge Assessment in Nursing (EKAN)

ABSTRACT Objective The Evidence-based Practice Knowledge Assessment in Nursing (EKAN) is an objective measure of evidence-based practice (EBP) knowledge. The aims of the project were to translate the EKAN instrument into Brazilian Portuguese, test its psychometric properties, and document a baseline assessment of students’ EBP knowledge. Method This study used methodological design. The EKAN-Brazilian Portuguese was administered to nursing students from two baccalaureate programs. Data were analyzed using Rasch procedures. Results 123 students participated (87% ranged 19-25 years old; 60% were juniors; 38% perceived having no exposure to EBP). Validity indices showed the mean difficulty index = -2.48 to 2.07, the Infit (WMS) mean was.985 (SD = 2.13), and the Outfit (UMS) mean was.975 (SD = 0.17). Reliability indices showed sufficient item separation index (4.47); moderate person separation index (.47); high item reliability (.95); and low person reliability (.18). The mean EKAN sum score (max = 20) was 7.6 (SD = 2.13). Conclusion This study on the EKAN-Brazilian Portuguese version provided sufficient evidence for validity and reliability; the person reliabilities showed the need for improvement in incorporating EBP concepts and content in nursing programs.

DEVELOPMENT OF A CHILDREN QUESTIONNAIRE FOR MEASURING CHINESE CHARACTER LITERACY LEARNING SATISFACTION

There are limited reports about development of questionnaire to measure learning satisfaction among young children. In this research, guidelines were listed for developing a questionnaire that gauges Chinese Character Literacy Learning Satisfaction (CCLLS) among 8-year-old children. The research was undertaken based on the responses of 232 children from 11 Chinese national type primary schools (SJKC) of Kota Kinabalu, Sabah, Malaysia. The CCLLS questionnaire consists of 12 items developed through three dimensions of satisfaction, which are (1) Satisfaction towards Chinese characters writing, (2) Satisfaction towards Chinese characters recognizing, (3) Satisfaction towards the learning in classroom. Rasch analysis was used to examine the item polarity. The result showed point measure correlation was within 0.47 – 0.60. The items were also detected with the outfit mean square in the range of 0.76 – 1.24, indicating CCLLS was fit to measure the children’s learning satisfaction. The raw variance explained by measures (33.3%), the unexplained variance in first contrast (9.1%), with the eigenvalue (1.6%) from the principal component analysis, suggested that CCLLS could be unidimensional. The internal consistency was considered very high with 0.81 in Cronbach’s alpha (KR-20). The result also showed CCLLS has very good item reliability (0.91) with good item separation index (3.23). The person reliability (0.77) was in satisfactory range with moderately good person separation index (1.81). The findings indicated that CCLLS questionnaire could be a valid and reliable tool in measuring Chinese character literacy learning satisfaction among 8-year-old primary school children of SJKC. Keywords: children questionnaire, Chinese Characters Literacy Learning Satisfaction, Rasch analysis, validity and reliability

Psychometric Properties of the CASP-12 Scale in Portugal: An Analysis Using SHARE Data

The purpose of this study is to assess the psychometric properties of the Portuguese version of the Control, Autonomy, Self-realization, and Pleasure (CASP)-12 scale used in the Survey of Health, Aging and Retirement in Europe (SHARE) project. Data were obtained from a representative sample of 1666 people aged ≥50 years living in Portugal and participating in the SHARE wave 6. In addition to the CASP-12 scale, sociodemographic data and health status, activity limitation (GALI), depression (Euro-D) and satisfaction with life scores were collected. Data quality and acceptability, construct and structural validity and internal consistency of the CASP-12 scale were analyzed. A Rasch analysis was also performed. CASP-12 total score (mean: 33.3; standard deviation: 5.8, range: 12–48) correlated with Euro-D (−0.57) and with life satisfaction (0.52). Mean scores were significantly lower for women, people aged ≥75 years and those with activity limitations and worse health status (p < 0.001). The confirmatory factor analysis showed good fit to the 4-factor model (root mean squared error of approximation (RMSEA): 0.07; comparative fit index (CFI): 0.90, χ2 (48) = 444.59, p < 0.001), which was confirmed by Rasch analysis (χ2 (36) = 10.089, p = 0.745, person separation index (PSI) = 0.722 for the 4-factor model). For domains, person separation index ranged 0.31–0.79 and Cronbach’s alpha, 0.37–0.73. In conclusion, the Portuguese version of the CASP-12 scale presents some inadequacies in acceptability, internal consistency and structural validity.