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한국형 건강 관련 삶의 질 측정도구(Health-Related Quality of Life Instrument with 8-Items)의 심리계량적 내적구조 평가: 국민건강영양조사 8기 1차년도 자료 적용
No full textPurpose: This study evaluated the internal structure (structural validity, internal consistency, and measurement invariance) of the Health-Related Quality of Life Instrument with Eight Items (HINT-8), developed to measure Korean people’s health-related quality of life. Methods: A secondary analysis was conducted using data from the Korea National Health and Nutrition Examination Survey, involving 6,167 adults aged over 18 years. The structural validity of the HINT-8 was assessed using exploratory graph analysis and confirmatory factor analysis. Internal consistency and measurement invariance were analyzed using McDonald’s omega (ω) and multigroup confirmatory factor analysis, respectively. Results: The HINT-8 had a single dimension and good internal consistency (ω =.804). The one-dimension HINT-8 exhibited matric invariance but not scalar invariance across sociodemographic groups (sex, age, education, and marital status). Further, it exhibited scalar or partial scalar invariance across medical condition groups (hypertension, diabetes, depressive symptoms, and cancer). Conclusion: The study finds that the HINT-8 demonstrated satisfactory structural validity and internal consistency, indicating its suitability for practice and research. However, the HINT-8 scores cannot be compared across different groups regarding sex, age, education, and marital status, as the interpretation varies within each sociodemographic category. Conversely, interpretation of the HINT-8 is consistent for individuals with and without hypertension, diabetes, depressive symptom, and cancer
초등학생 아들에 대한 부모의 인유두종바이러스 백신접종 의도와 예측요인: 개정된 계획된 행위이론의 적용
Get PDFPurpose: This study was to determine how attitude, subjective norm, and perceived behavioral control (PBC) were related to parents' intentions to vaccinate their sons in elementary school against human papillomavirus (HPV), applying the updated theory of planned behavior. Two hypotheses were examined: PBC would moderate the relationship of attitude to intention and subjective norm to intention, respectively. Methods: This was a cross-sectional study with 231 participants recruited in November, 2018. Inclusion criteria for the participants were parents with 5th-6th grade boys in elementary schools. The moderation effects of the hypotheses were analyzed using the PROCESS macro for SPSS. Results: PBC significantly moderated the relationship of attitude to intention on HPV vaccination. The simple effect of attitude to intention was significant under three different levels of the PBC (low, moderate, and high), but the magnitudes of the relationships were not homogeneous. The magnitude of the relationship between attitude and intention was the lowest for the parents with the low level of the PBC. In the relationship of subjective norm to intention on HPV vaccination, the moderating effect of the PBC was not supported. Subjective norm and PBC directly predicted the intention on HPV vaccination. Conclusion: In order to promote the parents' intentions to vaccinate their sons in elementary school against HPV, we need a program that can improve parents' attitude, subjective norm, and PBC, requiring special attention to the parents with the low PBC
Psychometric properties of an instrument 2: structural validity, internal consistency, and cross-cultural validity/measurement invariance
Get PDFStructural validity, internal consistency, and cross-cultural validity/measurement invariance are psychometric properties of the internal structure of an instrument. In psychometric studies published in Korean nursing journals, structural validity has mainly been assessed using confirmatory factor analysis. Cross-cultural validity/measurement invariance has rarely been evaluated. It is recommended for Korean nursing researchers to evaluate the internal structure of instruments using a greater variety of methods, such as item response theory, Rasch analysis, multi-group confirmatory factor analysis, and differential item functioning
Psychometric properties of an instrument 3: convergent, discriminant, known-groups, and criterion validity
Get PDFBefore evaluating convergent, discriminant, and known-groups validity, it is suggested to design an instrument that reflects hypothetical relationships or differences with other comparator instruments or groups. For criterion validity, a gold-standard instrument measuring the same construct should be carefully selected
Psychometric property of an instrument 4: reliability and responsiveness
Get PDFFor test-retest reliability, it is important to consider whether the attributes of the construct being measured is temporally stable or not. For responsiveness, it needs a longitudinal study design including a treatment/intervention known to induce a change on the construct to be measured
국내 학술지에 게재된 환자보고형 건강평가 측정도구에 대한 체계적 고찰연구의 현황
No full textPurpose: This study aimed to explore the current status of systematic review studies on patient-reported outcome measures (PROMS) published in Korean journals. Methods: Studies on the systematic review of PROMs, which applied the COnsensus-based Standards for selecting health Measurement Instruments (COSMIN) methodology. There were searched from the KoreaMed. The studies were evaluated based on the eight steps suggested by the COSMIN systematic review processes. Results: A total of eight systematic review studies were published in seven Korean journals. Patient-reported outcome measures (PROMS) measure for post-traumatic growth, social adjustment, physical impairment in post-intensive care syndrome, sleep quality, constipation, discharge readiness, post-traumatic stress disorder, and eHealth literacy. Conclusions: No studies adhered to the steps of the COSMIN systematic review guidelines. Among the steps, the weakest points were searching strategies and evaluating measurement properties
Internal Structure of the Patient Health Questionnaire-9: A Systematic Review and Meta-analysis
No full textPURPOSE: This review aimed to evaluate the internal structure (structural validity, internal consistency, and measurement invariance) of the Patient Health Questionnaire-9 (PHQ-9), which is one of the most widely used self-administered instruments for assessing and screening depression. METHODS: The updated COnsensus-based Standards for the selection of health Measurement Instruments methodology for a systematic review of self-reported instruments was used. PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library databases were searched from their inception up to February 28, 2023. RESULTS: This study reviewed 98 psychometric studies reported on in 90 reports conducted in 40 countries. Various versions of the PHQ-9 were identified: one-factor structures (8 types), two-factor structures (10 types), bifactor structures (4 types), three-factor structure (1 type), and second-order three-factor structure (1 type). There was sufficient high-quality evidence for structural validity of the one-factor structure with nine items scored using a four-point Likert scale based on confirmatory factor analysis, for internal consistency with a quantitatively pooled Cronbach alpha of .85, and for measurement invariance across sex, age, education level, marital status, and income groups. There was sufficient high-quality evidence for structural validity, internal consistency (Cronbach's alpha = .76- .92, omega = 0.83- .92), and measurement invariance across sex for the PHQ-8 (which excluded item 9: "suicidality or self-harm thoughts"). CONCLUSION: The one-factor PHQ-9 and PHQ-8 (excluding item 9) scored using a four-point Likert scale have the best internal structure based on the current evidence. The one-factor PHQ-9 and PHQ-8 justify the use of aggregated total scores in both practice and research. The total score of the PHQ-9 using a four-point Likert scale can be used to compare depression levels across sex, age, education level, marital status, and income groups due to the availability of sufficient evidence for measurement invariance across these demographic groups
Psychometric properties of the revised Diabetes Knowledge Test using Rasch analysis
No full textOBJECTIVE: The revised Diabetes Knowledge Test (DKT2) is the instrument that is the most widely used for measuring diabetes knowledge; nevertheless, its structural validity has never been evaluated. This study aimed to determine the psychometric properties of the DKT2. METHODS: This study performed a secondary data analysis of people with diabetes recruited at university hospitals. Rasch analysis was used. RESULTS: One item in the 14-item DKT2 measuring general diabetes knowledge exhibited a poor-fit, and so it was eliminated. The person-item map showed that items of greater difficulty need to be added to the instrument. The principal-components analysis of residuals revealed a unidimensional structure. The person reliability was 0.50, with a person separation index of 1.01. Measurement invariance was not satisfied for items 11 and 2 according to gender and age. CONCLUSIONS: The unidimensional structure of the 13-item DKT2 demonstrated poor person reliability and a low person separation index. Females and elderly persons found it more difficult to respond to items 11 and 2, respectively. PRACTICE IMPLICATIONS: Careful consideration is necessary when using the 13-item DKT2 in practice and research. It is recommended for future studies to add items of greater difficulty to the instrument
Measurement invariance of the patient health questionnaire-9 depression scale in a nationally representative population-based sample
No full textThe Patient Health Questionnaire-9 (PHQ-9) is widely used to measure the severity of depressive symptoms and to screen for depressive disorder, but its measurement invariance has received little research attention. The aim of this study was to assess the measurement invariance of the PHQ-9 across various sociodemographic and medical-condition groups. The structural validity and internal consistency of the PHQ-9 were also assessed as the prerequisite properties for measurement invariance. This study was conducted using data from the Korea National Health and Nutrition Examination Survey. The included participants comprised 5,347 people older than 19 years. Exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) were performed to determine structural validity, and the omega coefficient ((Formula presented.)) was used to determine internal consistency. Measurement invariance (configural, metric, and scalar invariance) was evaluated using multigroup confirmatory factor analysis (MGCFA). The single structural model of the PHQ-9 that was validated by EGA was also satisfactory with fit indices of χ2 = 770.765 (p < 0.001), CFI = 0.944, SRMR = 0.040, and RMSEA = 0.076 (90% CI = 0.072–0.081). The (Formula presented.) of the PHQ-9 was 0.812, implying satisfactory internal consistency. The one-factor PHQ-9 had equivalent overall structure, factor loadings, and item intercepts across age groups, suggesting invariance across ages. Partial scalar invariance was demonstrated across sex and marital-status groups. Partial metric and scalar invariance were supported across education groups. Scalar invariance was supported among all of the medical-condition (hypertension, diabetes, cancer, arthritis, asthma, and heart disease) groups. Overall, the measurement invariance of the one-factor PHQ-9 was empirically supported across sociodemographic and medical-condition groups. The PHQ-9 can be reliably used to compare the severity of depressive symptoms across these groups in research and practice
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