1,721,001 research outputs found
Scale Shortening and Decrease in Measurement Precision: Analysis of the Pain Self-Efficacy Questionnaire and Its Short Forms in an Italian-Speaking Population With Neck Pain Disorders
No full textOBJECTIVE: Short (2- and 4-item) forms of the Pain Self-Efficacy Questionnaire (PSEQ) have been proposed, but their measurement precision at the individual level is unclear.The purpose of this study was to analyze the Rasch psychometric characteristics of PSEQ and its 3 short forms (one 4-item and two 2-item versions) in an Italian-speaking population with neck pain disorders and compare their measurement precision at the individual level through calculation of the test information function (TIF).METHODS: Secondary analysis of data from a prospective single-group observational study was conducted. In 161 consecutive participants (mean age=45 y (SD=14); 104 women) with neck pain disorders, a Rasch analysis was performed on each version of PSEQ (full scale plus 3 short forms), and the TIF was calculated to examine the degree of measurement precision in estimating person ability over the whole measured construct (pain self-efficacy).RESULTS: In all versions of PSEQ, the rating scale fulfilled the category functioning criteria, and all items showed an adequate fit to the Rasch model. The TIF showed a bell-shaped distribution of information, with an acceptable measurement precision (standard error<0.5) for persons with a wide range of ability; conversely, measurement precision was unacceptably low in each short form (particularly the two 2-item versions).CONCLUSIONS: The results confirm and expand reports on the sound psychometric characteristics of PSEQ, showing for the first time its conditional precision in estimating pain self-efficacy measures in Italian individuals with neck pain disorders. The study cautions against use of the 3 PSEQ short forms for individual-level clinical decision making.IMPACT: Short scales are popular in rehabilitation settings largely because they can save assessment time and related costs. The psychometric characteristics of the 10-item PSEQ were confirmed and deepened, including its precision in estimating individual pain self-efficacy at different levels of this latent variable. On the other hand, low measurement precision of the 3 PSEQ short forms caution against their use for individual judgments
Construct validity of the Quebec Back Pain Disability Scale: a factor analytic and Rasch study
No full textStudies on structural validity of the Quebec Back Pain Disability Scale (QBPDS) showed uncertain unidimensionality
A further Rasch analysis of the Fear-Avoidance Beliefs Questionnaire in adults with chronic low back pain suggests the revision of its rating scale
No full textObjective: To examine the psychometric properties of the Fear-Avoidance Beliefs Questionnaire (FABQ) and its two subscales, in subjects with chronic low back pain (LBP).
Design: Methodological research based on a cross-sectional observational study.
Methods: A convenience sample of 155 Italian subjects with chronic LBP (57% men; mean age: 43±11 years; mean pain duration: 23±32 months) completed the FABQ. Rasch analysis was used to investigate dimensionality of the entire scale and key psychometric properties of its two subscales.
Results: The FABQ-Physical Activity (FABQ-PA) and FABQ-Work (FABQ-W) subscales showed two distinct unidimensional structures. Their 7-option rating categories were malfunctioning, but after collapsing problematic categories and omitting the central one ("Unsure") the new 4 categories (completely disagree; disagree; agree; completely agree) functioned as intended. After that and accommodation of local response dependency between two items in a testlet solution, each of the two subscales presented acceptable fit to the Rasch model (just one FABQ-W items was slightly underfitting). Person separation reliability was acceptable but not high (0.69 for FABQ-PA, and 0.79 for FABQ-W).
Conclusions: FABQ-PA and FABQ-W have adequate unidimensionality. A simplification of the response options of both subscales is strongly recommended to improve the technical quality of the scale. The reliability indexes suggest FABQ-PA and FABQ-W can be used for group judgements about level of fear-avoidance beliefs, but not for clinical decision-making in individuals. The selection of their items is acceptable, although - if future studies corroborate our results - there is room for some refinements to improve the general measurement quality.
Clinical rehabilitation impact: Fear-avoidance beliefs are associated with reduction of physical activity, and development of disability and deconditioning. This study examined the measurement properties of the two FABQ subscales, showing their essential unidimensionality, recommending the simplification of the rating categories, and discussing strengths and weaknesses of item selection. Our results extend the evidence for FABQ as a satisfactory (but improvable) measure of fear-avoidance beliefs in chronic LBP
Head-to-head Rasch comparison of the Prosthesis Evaluation Questionnaire-Mobility Section and the Prosthetic Mobility Questionnaire 2.0 in Italian lower-limb prosthesis Users
Full text linkThe Prosthesis Evaluation Questionnaire-Mobility Section (PEQ-MS) and the Prosthetic Mobility Questionnaire (PMQ 2.0) are two validated self-report questionnaires assessing mobility in people with lower-limb amputation
Responsiveness and minimal important change of the Quebec Back Pain Disability Scale in Italian patients with chronic low back pain undergoing multidisciplinary rehabilitation
Full text linkBackground: There is still a lack of information concerning MIC of the QBPDS, that limits its use for clinical and research purposes. Aim: Evaluating responsiveness and minimal important change (MIC) of the Quebec Back Pain Disability Scale (QBPDS) in Italians with chronic low back pain (LBP). Design: Methodological research based on an observational study. Setting: Outpatient rehabilitation hospital. Population: Two hundred and one patients with chronic LBP. Methods: At the beginning and end of a multidisciplinary rehabilitation programme, patients completed the QBPDS. At the end of treatment, they completed a 7-level global perceived effect (GPE) scale, which was split to obtain a dichotomous outcome (improved vs. stable). Responsiveness was calculated by distribution-based [effect size (ES); standardised response mean (SRM); minimum detectable change (MDC95)] and anchor-based methods [Receiver Operating Characteristics (ROC) curves]. ROC curves were also used to compute the MIC (based on QBPDS change score, both absolute and expressed as percentage). Correlations between the change score of the QBPDS and GPE were calculated. Results: The ES was 0.29, the SRM was 0.43, and the MDC95 was 12 points. ROC analysis of the absolute change scores showed a MIC value of 6 points, with an area under the curve (AUC), sensitivity, and specificity of 0.83 (95%C.I. 0.77-0.90), 77.7% and 80.8%, respectively. ROC analysis based on the percent change score from baseline revealed a MIC of 18% with an AUC, sensitivity and specificity of 0.85 (95%C.I. 0.79-0.91), 80.6% and 80.8%, respectively. Correlation between change score of the QBPDS and GPE was ρ=-0.67. Conclusions: The QBPDS score change (expressed in both absolute value and percentage from baseline) was sensitive in detecting clinical changes in Italian subjects with chronic LBP undergoing multidisciplinary rehabilitation. In clinical practice, we recommend -where absolute change is lower than MDC- to rely on the MIC taking into account the percentage change from baseline condition. Clinical rehabilitation impact: The present study investigated the responsiveness and MIC of the QBPDS in a group of patients with chronic LBP. Our findings showed that the QBPDS score may classify with good to excellent discriminatory accuracy subjects who consider themselves as improved. Where examining change, we recommend to consider both MICs we provided (expressing score change both in absolute value and as a percentage from baseline), and disregard values lower than MDC95, not being discernible from measurement error
Cross-cultural adaptation and validation of the Athlete Fear Avoidance Questionnaire in Italian university athletes with musculoskeletal injuries
No full textThe aim of this study was to translate, culturally adapt and validate an Italian version of the Athlete Fear Avoidance Questionnaire (AFAQ-I). We conducted a cross-sectional evaluation of the psychometric properties of the AFAQ-I in university athletes with musculoskeletal injuries, culturally adapting it in accordance with international standards. Psychometric evaluation included the assessment of structural validity (exploratory factor analysis), internal consistency (Cronbach's alpha and inter-item correlation), test-retest reliability [intraclass correlation coefficient, (ICC) (2,1)], measurement error and minimum detectable change (MDC). To examine construct validity, we compared (Spearman ρ) the AFAQ-I with a numerical pain rating scale (NPRS), the Pain Catastrophizing Scale (PCS) and the Fear Avoidance Beliefs Questionnaire (FABQ) subscales [FABQ-Physical Activity (FABQ-PA) and FABQ-Work (FABQ-W)]. The AFAQ-I was administered to 133 university athletes with musculoskeletal injuries (95 males and 38 females; mean age 25 years, SD 5; mean average pain duration 5.6 months, SD 8.7). Factor analysis revealed an acceptable 1-factor 10-item solution (explained common variance at minimum rank factor analysis: 0.74) although a couple of items (#6 and 9) presented low factor loadings, suggesting the presence of a small secondary dimension. Cronbach's alpha was 0.78 and the average inter-item correlation was 0.27. ICC (2,1) was 0.95 and the MDC was 4.4 points. As hypothesized a priori, the AFAQ-I moderately correlated with NPRS (ρ = 0.42), PCS (ρ = 0.59), FABQ-PA (ρ = 0.40) and FABQ-W (ρ = 0.34). In conclusion, the AFAQ-I is a valid Italian translation of AFAQ that demonstrates acceptable psychometric properties. However, we recommend further analysis of the construct definition of the AFAQ and additional examination of its structural validity
Using psychometric techniques to improve the balance evaluation systems test: The mini-bestest
No full textOBJECTIVE: To improve, with the aid of psychometric analysis, the Balance Evaluation Systems Test (BESTest), a tool designed to analyse several postural control systems that may contribute to poor functional balance in adults.
METHODS: Performance of the BESTest was examined in a convenience sample of 115 consecutive adult patients with diverse neurological diagnoses and disease severity, referred to rehabilitation for balance disorders. Factor (both explorative and confirmatory) and Rasch analysis were used to process the data in order to produce a new, reduced and coherent balance measurement tool.
RESULTS: Factor analysis selected 24 out of the 36 original BESTest items likely to represent the unidimensional construct of "dynamic balance". Rasch analysis was then used to: (i) improve the rating categories, and (ii) delete 10 items (misfitting or showing local dependency). The model consisting of the remaining 14 tasks was verified with confirmatory factor analysis to meet the stringent requirements of modern measurement.
CONCLUSION: The new 14-item scale (dubbed mini-BESTest) focuses on dynamic balance, can be conducted in 10-15 min, and contains items belonging evenly to 4 of the 6 sections from the original BESTest. Further studies are needed to confirm the usefulness of the mini-BESTest in clinical settings
Blurred lines between axillary web syndrome and Mondor's disease after breast cancer surgery: A case report
No full textResponsiveness and minimal important change of the Pain Catastrophizing Scale in people with chronic low back pain undergoing multidisciplinary rehabilitation
No full textThe Pain Catastrophizing Scale (PCS), a widely used tool to assess catastrophizing related to spinal disorders, shows valid psychometric properties in general but the minimal important change (MIC) is still not determined
Comparison of reliability, validity, and responsiveness of the Mini- BESTest and berg balance scale in patients with balance disorders
No full textBACKGROUND: Recently, a new tool for assessing dynamic balance impairments has been presented: the 14-item Mini-BESTest.
OBJECTIVE: The aim of this study was to compare the psychometric performance of the Mini-BESTest and the Berg Balance Scale (BBS).
DESIGN: A prospective, single-group, observational design was used in the study.
METHODS: Ninety-three participants (mean age=66.2 years, SD=13.2; 53 women, 40 men) with balance deficits were recruited. Interrater (3 raters) and test-retest (1-3 days) reliability were calculated using intraclass correlation coefficients (ICCs). Responsiveness and minimal important change were assessed (after 10 sessions of physical therapy) using both distribution-based and anchor-based methods (external criterion: the 15-point Global Rating of Change [GRC] scale).
RESULTS: At baseline, neither floor effects nor ceiling effects were found in either the Mini-BESTest or the BBS. After treatment, the maximum score was found in 12 participants (12.9%) with BBS and in 2 participants (2.1%) with Mini-BESTest. Test-retest reliability for total scores was significantly higher for the Mini-BESTest (ICC=.96) than for the BBS (ICC=.92), whereas interrater reliability was similar (ICC=.98 versus .97, respectively). The standard error of measurement (SEM) was 1.26 and the minimum detectable change at the 95% confidence level (MDC(95)) was 3.5 points for Mini-BESTest, whereas the SEM was 2.18 and the MDC(95) was 6.2 points for the BBS. In receiver operating characteristic curves, the area under the curve was 0.92 for the Mini-BESTest and 0.91 for the BBS. The best minimal important change (MIC) was 4 points for the Mini-BESTest and 7 points for the BBS. After treatment, 38 participants evaluated with the Mini-BESTest and only 23 participants evaluated with the BBS (out of the 40 participants who had a GRC score of ≥ 3.5) showed a score change equal to or greater than the MIC values.
LIMITATIONS: The consecutive sampling method drawn from a single rehabilitation facility and the intrinsic weakness of the GRC for calculating MIC values were limitations of the study.
CONCLUSIONS: The 2 scales behave similarly, but the Mini-BESTest appears to have a lower ceiling effect, slightly higher reliability levels, and greater accuracy in classifying individual patients who show significant improvement in balance function
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