Psychometric Validation of an Instrument for Measuring Patient Experiences with Outpatient Healthcare.

Aim: Recently, a patient-reported experience measure (PREM) was developed in Slovenia to assess patients' experiences with outpatient specialist healthcare clinics. The aim of this study was to evaluate the psychometric properties (including factor structure, reliability, convergent validity, and response distribution) of the questionnaire. Methods: The sample consisted of 8,406 adult participants treated in 171 specialist clinics from different medical fields. Participants voluntarily and anonymously responded to either the paper or online survey. Results: Descriptive statistics show meaningful response patterns with a general tendency towards favourable assessments. The psychometric analyses of the scales evaluating doctor's and nurses' work, respectively, generally showed a good fit of the unidimensional factor model as well as the Rasch model, high factor loadings and very good to satisfactory reliability. The Rasch scaling showed that these scales were most informative for patients with relatively unfavourable experience ratings. Conclusions: The results are similar to those found in previous evaluations of PREMs in other countries. Given its good psychometric properties, the Slovenian PREM can be recommended for healthcare evaluations in Slovenia and as a model for the development of similar PREMs in other countries.

The effects of survey mode on self-reported psychological functioning: Measurement invariance and latent mean comparison across face-to-face and web modes.

Despite the increasing popularity of mixed-mode approaches to data collection, studies examining measurement equivalence across different survey modes in representative samples of the general population, particularly focusing on measures of socially sensitive psychological constructs, are sparse. In this study, we used data from a large representative sample of the Slovenian population (N = 9,900) collected as part of the third wave of the European Health Interview Survey (EHIS) to examine mode-inherent effects (i.e., measurement effects that cannot be neutralized by clever survey design) of the traditional interviewer-mediated face-to-face mode and the increasingly popular self-administered web mode on three measures of psychological functioning, namely the Patient Health Questionnaire Depression Scale (PHQ-8), the Satisfaction with Life Scale (SWLS), and the Mental Health Continuum - Short Form (MHC-SF). After controlling for self-selection propensities, our results showed strict measurement invariance for all three scales across the two survey modes, but statistically significant and notable differences in latent means, suggesting that individuals who respond face-to-face systematically report better psychological functioning than individuals who respond over the web. These results suggest significant mode inherent effects that cannot be attributed to measurement non-invariance of the scales between face-to-face and web survey modes, but most likely to social desirability bias in responses achieved in the presence of an interviewer. Administration mode effects must be considered when interpreting and comparing results obtained through different survey modes, particularly interviewer-mediated versus self-administered modes, especially when using measures of culturally desirable traits and behaviors, such as mental health and well-being.

Measurement Invariance of the Subjective Happiness Scale Across Countries, Gender, Age, and Time.

The purpose of this study was to examine measurement invariance of the Subjective Happiness Scale across countries, gender, and age groups and across time by multigroup confirmatory factor analysis. Altogether, 4,977 participants from nine European, American, and Australian countries were included in the study. Our results revealed that both configural and metric invariance held across countries, but scalar invariance was only partially confirmed with one item yielding varying intercepts in different countries. Measurement invariance was also confirmed across gender and age groups. Longitudinal measurement invariance was examined on a subsample of 478 English-speaking participants and was fully confirmed across five consecutive assessment points. Factor means were compared between groups and across time, and good convergent validity of the Subjective Happiness Scale was found in relation to a measure of temporal satisfaction with life. Overall, our results demonstrate that self-reported happiness was measured similarly in nine different countries, gender and age groups and over time, and provide a solid foundation for meaningful cross-group and cross-time comparisons in subjective happiness.

Validation of the Slovenian Version of Short Sense of Coherence Questionnaire (SOC-13) in Multiple Sclerosis Patients.

AIM: To validate the Slovenian version (SOC-13-SVN) of Sense of Coherence 13-item instrument (SOC-13) in Slovenian multiple sclerosis (MS) patients. METHODS: A consecutive 134 Slovenian MS patients were enrolled in a cross-sectional study in 2013. The reliability of the SOC-13-SVN was assessed for internal consistency by Cronbach's alpha coefficient (α), dimensionality by the confirmatory factor analysis (CFA), and criterion validity by Pearson correlation coefficient (r) between SOC-13-SVN global score and MSQOL-54 composite scores - Mental Health Composite score (MHC) and Physical Health Composite score (PHC). RESULTS: For the SOC-13-SVN instrument as a whole, internal consistency was high (αtotal=0.88) while it was low for three subscales (αcomprehensibility=0.79; αmanageability=0.66; αmeaningfulness=0.69). The results of the CFA confirmed a three-factor structure with good fit (RMSEA=0.059, CFI=0.953, SRMR=0.065), however, the correlations between the factors were very high (rcomprehensibility/manageability=0.938; rcomprehensibility/meaningfulness=0.811; rmanageability/meaningfulness=0.930). The criterion validity analysis showed a moderate positive strength of relationship between SOC-13-SVN global score and both MSQOL-54 composite scores (MHC: r=0.597, p<0.001; PHC: r=0.437, p<0.001). CONCLUSION: Analysis of some psychometric properties confirmed that this instrument is a reliable and valid tool for use in Slovenian MS patients. Despite the three-dimensional structure of the instrument, the use of the global summary score is encouraged due to the low reliability of the subscale scores and high correlations between them.

Measuring self-care in patients with heart failure: A review of the psychometric properties of the European Heart Failure Self-Care Behaviour Scale (EHFScBS).

OBJECTIVE: The aim of this study was to review and evaluate the evidence related to psychometric properties of the European Heart Failure Self-Care Behaviour Scale (EHFScBS) that was developed and tested to measure health maintenance behaviours of heart failure (HF) patients and translated into several languages. METHODS: PRISMA guidelines were used to search major health databases (PubMed, Scopus and ScienceDirect), to identify relevant studies. A literature search was undertaken in November 2015. An integrative review, aiming to bring together all evidence relating to the psychometric properties (validity, reliability) of the EHFScBS was conducted. RESULTS: 13 eligible studies were included. The results showed content, discriminant and convergent validity of the 9- and 12-item scale across the samples, while the factor structure of both versions of the scale was inconsistent. Most commonly used reliability estimates (Cronbach's alpha) of the total scale were satisfactory. CONCLUSION: Overall, published data demonstrate satisfactory psychometric properties of the EHFScBS, indicating that the scale is a reliable and valid tool for measuring health maintenance behaviours of HF patients. PRACTICE IMPLICATIONS: Taking the findings regarding the factorial structure of the scale into account, we recommend the use of the total EHFScBS score or scores on specific items.

Early vocabulary, parental education, and the frequency of shared reading as predictors of toddler's vocabulary and grammar at age 2;7: a Slovenian longitudinal CDI study.

The aim of this longitudinal study, carried out on a sample of Slovenian-speaking toddlers, was to analyze developmental changes and stability in early vocabulary development; to establish relations between toddler's vocabulary and grammar; and to analyze the effects of parental education and the frequency of shared reading on toddlers' vocabulary and grammar. The sample included fifty-one toddlers, aged 1;4 at the time of the first, and 2;7 at the time of the last, assessment. Toddlers' vocabulary and grammar were assessed six times during a 15-month period using the Slovenian adaptation of the CDI. Our findings suggest great individual differences in both size and rate of toddlers' vocabulary development. Toddlers' vocabulary scores remained relatively stable across a 3-month period. Early vocabulary at 1;7 predicted vocabulary, sentence complexity, and mean length of utterance (MLU) at 2;7, while the frequency of shared reading mediated the effect of parental education on toddlers' vocabulary and grammar at 2;7.

Parental evaluation of processes of care in relation to the child, parent and family characteristics.

The Measure of Processes of Care (MPOC) is a questionnaire for parents used to evaluate the behaviours of healthcare providers. We applied its 20-item version (MPOC-20) to explore the associations between parental evaluation of processes of care and child, parent and family characteristics in Slovenia. A novelty of our approach was the emphasis on the role of a key person. Parents of 235 children who were admitted as inpatients or outpatients of six institutions (hospitals and health centres) because of chronic illness or disability participated in the study. Parents were asked to fill in a general questionnaire on several characteristics of the child, child's health problems, the family and the therapy programmes, and MPOC-20. Univariate associations of the five MPOC-20 scale scores with child, parent and family characteristics were tested first. Multiple linear regression was used for modelling scale scores in relation to child, parent and family characteristics. The analyses singled out availability of a key person as the factor most consistently and unequivocally influencing parental satisfaction. We also found a general positive effect of male sex of the child on the MPOC-20 scores. Neither the present age of children nor age at the onset of health problems was found to be associated with MPOC-20 scores. We found no notable association of the number of health problems with the MPOC-20 scores, but observed clear differences when comparing parental satisfaction with processes of care between different participating institutions.

Development and construct validation of the Individuation Test for Emerging Adults (ITEA).

This article presents the construction, exploratory dimensionality analysis (Study 1), and validation (Study 2) of the self-report and 36-item Individuation Test for Emerging Adults (ITEA). It is the first instrument to measure different aspects of individuation (in relation to mother and father) specifically in emerging adulthood. The construct validity of the final 5-factor structure (Support Seeking, Connectedness, Intrusiveness, Self-Reliance, and Fear of Disappointing the Parent) was satisfactory. The results of multigroup analyses demonstrated that the factor structure is stable across male and female emerging adults for ITEA assessments in relation to both mother and father. The ITEA scales also show good internal consistency and concurrent validity against Emotional, Conflictual, and Functional Dependence scales of the Psychological Separation Inventory.

Expert and lay explanations of suicidal behaviour: comparison of the general population's, suicide attempters', general practitioners' and psychiatrists' views.

BACKGROUND: Different explanations of suicidal behaviour coexist today. The incompatibility of the beliefs among experts and (potential) users of medical services can influence the implementation of prevention programmes, help-seeking behaviour and adherence to treatment. AIMS: The aims of the study were to identify explanatory models of suicidal behaviour and to determine possible incompatibilities between lay (the general population and suicide attempters) and expert (the general practitioners and psychiatrists) views. METHODS: The Questionnaire on Attitudes towards Suicide was revised on the basis of semi-structured interviews with the general population, suicide attempters, general practitioners and psychiatrists. The revised version was then applied to each of these four groups. RESULTS: Five explanatory models were identified: namely, personality, sociological, medical, crisis and genetic models. Significant group differences on the explanatory models were found. The lay people favoured crisis, sociological and medical models whereas the experts shared the belief in the medical, genetic and crisis models. CONCLUSIONS: The crisis model gained considerable support and was generally accepted as correct. This could be the common ground between lay people and experts and the starting point of both treatment and prevention programmes.