Background: Objective assessment of pain-related behaviours is crucial in adults with profound intellectual and multiple disabilities. No standardised pain observation instrument that specifically focuses on this target group is currently available. A previous study identified 12 pain-related behaviours in these persons. This study aimed to develop a valid and reliable instrument based on these 12 pain-related behaviours to assess pain in these adults in daily situations. Method: Videos of 91 adults with profound intellectual and multiple disabilities in potentially painful daily situations were scored using the 12 pain-related behaviour items. Mokken scale analysis was used to determine the construct validity of these items. Results: Analysis resulted in a 9-item scale (H =.46, Rho =.70), which appeared to be sample independent for the variables of sex, age and level of motor functioning. Conclusion: A scale containing 9 items (APOS-PIMD) with reasonable construct validity and sufficient reliability was developed, which can be used to measure pain in adults with profound intellectual and multiple disabilities in daily situations.
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A burden scale is described that is conceptually specific by concentrating on an assessment of different aspects of distress of care-giving burden and conceptually sensitive by distinguishing two dimensions: the relationship of the carer and the care-receiver and the limitations in the personal life of the carer. To develop a burden scale an analysis was carried out on a database of an intervention study in which 89 informal caregivers of psychogeriatric patients were interviewed twice. A principal components analysis was carried out showing two main factors that could be interpreted as the two dimensions mentioned above. Reliability analysis showed a Cronbach's alpha of 0.84 for the total care-giving burden scale (13 items) and 0.77 for both subscales (7 and 6 items), confirmed in an independent sample. An analysis of the hierarchy of items (Mokken Scale Analysis) showed a strong and moderate hierarchy for the subscales and the total scale, respectively. Finally, an analysis of construct validity showed strong correlations of care-giving burden with depression of the carer and deviant behaviour of the patient.
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BackgroundWe report development of the SPQ (School Participation Questionnaire) a teacher-completed measure of participation related constructs for schools. The SPQ was developed to support participation-related assessment, interventions, and research in the inclusive school context.MethodsSeveral iterative steps were undertaken. An international panel of experts reviewed content validity. A 66-item pilot questionnaire was administered in schools. Mokken and Rasch model analysis were applied. Internal consistency was assessed using Cronbach’s alpha. Analyses were conducted on associations with teacher and child demographic variables. Feedback was sourced from users. Participants were teachers of 101 children (5−12 years old) with a range of disabilities, including intellectual disability, autism spectrum disorder and learning difficulties.ResultsFour participation-related dimensions of the SPQ were confirmed. Rasch person and item reliability were good, and 2–4 strata were confirmed per scale. Internal consistency was good (all scales, Cronbach α > 0.8). Mean administration time was 11.7 min. Mean SPQ scores were independent of teacher characteristics. A significant effect of school support level, eligibility for free school meals and gender was found. Through synthesising analytic results and feedback, a new 46-item tool was obtained.ConclusionThe results of this study provide evidence of acceptability, practicality and validity. The SPQ is the first tool developed to assess participation related constructs in schools, and it contains novel information not given by other assessments. The SPQ may be used by practitioners and researchers to understand and improve the participation of children with a range of disabilities in schools.
MULTIFILE
BACKGROUND: Due to the rapidly increasing number of older people worldwide, the prevalence of frailty among older adults is expected to escalate in coming decades. It is crucial to recognize early onset symptoms to initiate specific preventive care. Therefore, early detection of frailty with appropriate screening instruments is needed. The aim of this study was to evaluate the underlying dimensionality of the Groningen Frailty Indicator (GFI), a widely used self-report screening instrument for identifying frail older adults. In addition, criterion validity of GFI subscales was examined and composition of GFI scores was evaluated.METHODS: A cross-sectional study design was used to evaluate the structural validity, internal consistency and criterion validity of the GFI questionnaire in older adults aged 65 years and older. All subjects completed the GFI questionnaire (n = 1508). To assess criterion validity, a smaller sample of 119 older adults completed additional questionnaires: De Jong Gierveld Loneliness Scale, Hospital Anxiety Depression Scale, RAND-36 physical functioning, and perceived general health item of the EuroQol-5D. Exploratory factor analysis and Mokken scale analysis were used to evaluate the structural validity of the GFI. A Venn diagram was constructed to show the composition of GFI subscale scores for frail subjects.RESULTS: The factor structure of the GFI supported a three-dimensional structure of the scale. The subscales Daily Activities and Psychosocial Functioning showed good internal consistency, scalability, and criterion validity (Daily Activities: Cronbach's α = 0.81, Hs = .84, r = -.62; Psychosocial Functioning: Cronbach's α = 0.80, Hs = .35, r = -.48). The subscale Health Problems showed less strong internal consistency but acceptable scalability and criterion validity (Cronbach's α = .57, Hs = .35, r = -.48). The present data suggest that 90% of the frail older adults experience problems in the Psychosocial Functioning domain.CONCLUSIONS: The present findings support a three-dimensional factor structure of the GFI, suggesting that a multidimensional assessment of frailty with the GFI is possible. These GFI subscale scores produce a richer assessment of frailty than with a single overall sum GFI score, and likely their use will contribute to more directed and customized care for older adults.
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AIM: To explore concurrent validity, convergent validity, interrater reliability, test-retest reliability, and Rasch model analysis of the School Participation Questionnaire (SPQ), a tool for teachers to assess personal and environmental determinants of school participation.METHOD: Teachers of children with additional support needs, including intellectual disability, autism, and learning difficulties completed measures. Data were collected using the SPQ and the Participation and Environment Measure for Children and Youth (PEM-CY). Test-retest and interrater reliability were assessed using intraclass correlation coefficients (ICCs). Internal consistency was assessed with Cronbach's alpha. Concurrent and convergent validity were explored via correlations with the PEM-CY. Further psychometrics were examined using a Rasch model.RESULTS: One hundred and eighty-seven children (136 [72.7%] male; mean age 9y [range 5y 6mo-12y 10mo, SD 2y]) were assessed by 67 teachers. Cronbach's alpha, test-retest, and interrater reliability were acceptable-excellent across each SPQ scale (alphas=0.89, 0.9, 0.94, 0.79; test-retest ICCs=0.64, 0.61, 0.78, 0.62; interrater ICCs=0.85, 0.71, 0.90, 0.81). Concurrent and convergent validity were confirmed with significant positive correlations between SPQ and PEM-CY. After Mokken and Rasch model analysis, person and item reliability were good, and unidimensionality was confirmed. Mean administration time was 8.2 minutes.INTERPRETATION: The results suggest that the SPQ is a rapid, reliable, and valid tool for assessment of participation-related indicators in schools.
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Many children aged 9–12 appear to have low levels of fundamental movement skills (FMS). Physical education (PE) is important because PE-teachers can teach children a variety of FMS and can influence PE-motivation. However, declined levels of PE-motivation are reported in the final grades of elementary school. Therefore, more insight in the relations between PE-motivation and FMS is needed.Purposes: In the first phase, instruments to measure the satisfaction of basic psychological needs (competence, autonomy, classmate relatedness and teacher relatedness) and PE-motivation (autonomous and controlled) in 9–12-year-old children were developed and validated. The purpose of the second phase was to examine the influence of basic psychological needs on PE-motivation, the influence of PE-motivation on locomotor skills, object control skills and balance skills, and the direct influence of basic psychological needs on FMS for boys and girls aged 9–12.Participants and data collection: In the first phase, 172 children (82 boys, 90 girls, M = 10.72 years ± 0.77) filled out questionnaires assessing the satisfaction of their basic psychological needs and motivation for PE. Forty-eight children completed the questionnaires again 4 weeks later. In the second phase, a total of 138 children (66 boys, 72 girls, 10.8 years ± .79) (three schools from phase 1 and one new school) participated. Children from the new school also completed the questionnaires and all children conducted the subtest for speed and agility, upper limb coordination and balance of the Bruininks-Oseretsky Test of Motor Proficiency 2.Data analysis: In phase 1, linear weighted Kappa's and the Mokken Scale Program for polychotomous items were used to test reliability and validity. In phase 2, Pearson's correlations and multiple linear regression analyses were performed to examine the relations.Findings: Regarding phase 1, all subscales were reliable and the validity was considered moderate to strong except for the autonomy subscale, which was not reliable and valid. With respect to phase 2, all basic psychological needs, except autonomy among girls, had moderate to strong correlations with autonomous PE-motivation. Teacher relatedness was the most important predictor for boys and girls, while the second predictor was classmate relatedness for boys and competence for girls. No positive significant relations between basic psychological needs and FMS and between PE-motivation and FMS were found. In contrary, moderate but negative relations between teacher relatedness and balance skills and between autonomous PE-motivation and balance skills were found for boys.Conclusions: The results confirmed the importance of the basic psychological needs in the prediction of autonomous PE-motivation in 9–12-year-old children. Although all needs should be supported by the PE-teacher, it is important to be aware of the different impact of the needs on autonomous PE-motivation for boys and girls. Despite the missing relations with FMS, PE-teachers seem to be able to autonomously motivate children for PE regardless of their FMS proficiency.
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