A multidimensional Rasch analysis of the screener and opioid assessment for patients with pain-revised.

OBJECTIVE: Pilot study to assess psychometric indices of the screener and opioid assessment for patients with pain-revised (SOAPP-R©) with item response theory. DESIGN: Correlational. SETTING: Patients. OUTCOME MEASURES: The SOAPP-R©, the pain self-efficacy questionnaire (PSE-Q), and the patient health questionnaire-9 (PHQ-9) and a demographic -questionnaire. RESULTS: A three-dimensional model provided the best fit for the SOAPP-R© item responses, with scales entitled drug-alcohol concerns, pain medication, and emotional stress; reliabilities were 0.77, 0.71, and 0.80 for those three scales. Significant correlations were found with the PSE-Q, the PHQ-9, and the SPQ for the drug-alcohol scale but not for the two remaining scales. CONCLUSIONS: The SOAPP-R© showed invariance and support for validity, but with a three-dimensional scale structure.

Assessing the Reliability of the Framework for Equitable and Effective Teaching With the Many-Facet Rasch Model.

This manuscript reports results of an empirical assessment of a newly developed measure designed to assess apprentice teaching proficiency. In this study, Many Facets Rasch model software was used to evaluate the psychometric quality of the Framework for Equitable and Effective Teaching (FEET), a rater-mediated assessment. The analysis focused on examining variability in (1) supervisor severity in ratings, (2) level of item difficulty, (3) time of assessment, and (4) teacher apprentice proficiency. Added validity evidence showed moderate correlation with self-reports of apprentice teaching. The findings showed support for the FEET as yielding reliable ratings with a need for added rater training.

A Rasch analysis of the Current Opioid Misuse Measure for patients with chronic pain.

OBJECTIVE: Pilot study to assess psychometric indices of the Current Opioid Misuse Measure (COMM). DESIGN: Correlational. SETTING: Patients with varied chronic pain from a family healthcare center. PATIENTS: Inclusion criteria were over 21 years of age and prescribed opioids for any-origin noncancer pain; 46 patients were enrolled. OUTCOME MEASURE(S): The COMM, the Pain Self-Efficacy Questionnaire (PSE-Q), and the Patient Health Questionnaire-9 (PHQ-9) and a demographic -questionnaire. RESULTS: Preliminary analysis indicated issues with dimensionality and scale use. Analysis after remedial procedures yielded unidimensionality and appropriate scale use, with the measure showing invariance across sex and low significant correlation with the PHQ-9 but not the PSE-Q. CONCLUSIONS: The COMM had adequate reliability, measured a distinct construct, and no significant differential item function was found. However, scale use for this sample was questionable, and three items misfit the Rasch model. Replication with a larger sample is needed to ensure the measure's psychometric quality for diagnostic use.

Evaluation of the Parent-Report Inventory of Callous-Unemotional Traits in a Sample of Children Recruited from Intimate Partner Violence Services: A Multidimensional Rasch Analysis.

OBJECTIVE: Our study applied multidimensional item response theory (MIRT) to compare structural models of the parent-report version of the Inventory of Callous and Unemotional Traits (ICU; English and North American Spanish translations). METHOD: A total of 291 maternal caregivers were recruited from community-based domestic violence services and reported on their children (77.9% ethnic minority; 47% female), who ranged in age from 7 to 12 years (mean = 9.07, standard deviation = 1.64). We compared 9 models that were based on prior psychometric evaluations of the ICU. RESULTS: MIRT analyses indicated that a revised 18-item version comprising 2 factors (callous-unemotional and empathic-prosocial) was more suitable for our sample. Differential item functioning was found for several items across ethnic and language groups, but not for child gender or age. Evidence of construct validity was found. CONCLUSION: We recommend continued research and revisions to the ICU to better assess the presence of callous-unemotional traits in community samples of school-age children.

Rasch analysis of the Rosenberg Self-Esteem Scale with African Americans.

Effectively diagnosing African Americans' self-esteem has posed an unresolved challenge. To address this assessment issue, we conducted exploratory factor analysis and Rasch analysis to assess the psychometric characteristics of the Rosenberg Self-Esteem Scale (RSES, Rosenberg, 1965) for African American college students. The dimensional structure of the RSES was first identified with the first subsample (i.e., calibration subsample) and then held up under cross-validation with a second subsample (i.e., validation subsample). Exploratory factor analysis and Rasch analysis both supported unidimensionality of the measure, with that finding replicated for a random split of the sample. Response scale use was generally appropriate, items were endorsed at a high level reflecting high levels of self-esteem, and person separation and reliability of person separation were adequate, and reflected results similar to those found in prior research. However, as some categories were infrequently used, we also collapsed scale points and found a slight improvement in scale and item indices. No differential item functioning was found by sex or having received professional assistance versus not; there were no mean score differences by age group, marital status, or year in college. Two items were seen as problematic. Implications for theory and research on multicultural mental health are discussed. (PsycINFO Database Record

Assessing exertional dyspnea in patients with idiopathic pulmonary fibrosis.

BACKGROUND: Dyspnea is a hallmark symptom of idiopathic pulmonary fibrosis (IPF), and dyspnea induced physical activity limitation is a prominent driver of quality of life impairment among IPF patients. METHODS: We examined response data for the 21 physical activity items (the first 21 of 24) from the University of California San Diego Shortness of Breath Questionnaire (UCSD) collected at baseline in a recently conducted IPF trial. We used Rasch analysis and hypothesis testing with conventional statistical methodology to achieve three objectives: 1) to examine the items to identify the one characteristic that distinguishes one from another; 2) to asses these items for their ability to measure dyspnea severity in IPF; 3) to use the items to develop a dyspnea ruler. RESULTS: The sample comprised 178 subjects. The 21 items fit the Rasch model. There was very strong correlation between Rasch item severity and their metabolic equivalents (METS) values (r = -0.86, p < 0.0001). With the sample stratified on scores from the 21 items, there were significant between group differences in FVC%, DLCO% and distance walked during the six-minute walk test. The dyspnea ruler can be used to put dyspnea levels in a more easily understood clinical context. CONCLUSIONS: The first 21 items from the UCSD compose a unidimensional dyspnea-with-activity scale and are both sensibly ordered and distinguished from each other by their METS values. These 21 items can be used confidently to formulate clinically-relevant inferences about IPF patients and should be considered for use as a meaningful endpoint in IPF research.

Rasch analysis of the Outcome Questionnaire with African Americans.

Effectively diagnosing African Americans' mental health with a single intake checklist has posed an unresolved challenge, as most intake checklists were developed from White perspectives. In this study, Rasch analysis was used to assess the psychometric characteristics of a common measure of clinical distress, the Outcome Questionnaire (OQ; Lambert, Lunnen, Umphress, Hansen, & Burlingame, 1994), for a sample of African American students split into a calibration and validation subsample. OQ subscales were first identified and were then held up under cross-validation with a second subsample. Rasch analysis of the OQ clearly indicated the measure was multidimensional among African American students with 2 subscales titled Well-Being and Psychological Distress. Our results also indicated appropriate response scale use, adequate person separation, strong stability across subsamples, and little differential item functioning. Moreover, our analysis showed items of the 2 subscales to be well-targeted for African American students. However, if subscales were to be revised for African American students, some items at the same logit position might be deleted and replaced with either very easy or more difficult items or with items at intermediate positions to extend and to fill in gaps in construct coverage. Implications for theory and research on multicultural mental health scales were discussed.

Cognitive assessment in mathematics with the least squares distance method.

This study investigated the validation of comprehensive cognitive attributes of an eighth-grade mathematics test using the least squares distance method and compared performance on attributes by gender and region. A sample of 5,000 students was randomly selected from the data of the 2005 Turkish national mathematics assessment of eighth-grade students. Twenty-five math items were assessed for presence or absence of 20 cognitive attributes (content, cognitive processes, and skill). Four attributes were found to be misspecified or nonpredictive. However, results demonstrated the validity of cognitive attributes in terms of the revised set of 17 attributes. The girls had similar performance on the attributes as the boys. The students from the two eastern regions significantly underperformed on the most attributes.

Multiculturally Sensitive Mental Health Scale (MSMHS): development, factor analysis, reliability, and validity.

Effectively and efficiently diagnosing African Americans' mental health has been a chronically unresolved challenge. To meet this challenge we developed a tool to better understand African Americans' mental health: the Multiculturally Sensitive Mental Health Scale (MSMHS). Three studies reporting the development and initial validation of the MSMHS were conducted with African American student samples. First, an exploratory factor analysis of an initial item pool yielded 5 factors assessing subscales of perceived racism, depression, well-being, anxiety, and suicidal thoughts. Second, a confirmatory factor analysis supported the MSMHS's 5-dimensional factor structure. Third, test-retest reliability, internal consistency, and validity coefficients supported the viability, use, and potential for continued development of this new instrument. Implications for theory and research on multicultural mental health scales are discussed.

Development of the ATAQ-IPF: a tool to assess quality of life in IPF.

BACKGROUND: There is no disease-specific instrument to assess health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF). METHODS: Patients' perspectives were collected to develop domains and items for an IPF-specific HRQL instrument. We used item variance and Rasch analysis to construct the ATAQ-IPF (A Tool to Assess Quality of life in IPF). RESULTS: The ATAQ-IPF version 1 is composed of 74 items comprising 13 domains. All items fit the Rasch model. Domains and the total instrument possess acceptable psychometric characteristics for a multidimensional questionnaire. The pattern of correlations between ATAQ-IPF scores and physiologic variables known to be important in IPF, along with significant differences in ATAQ-IPF scores between subjects using versus those not using supplemental oxygen, support its validity. CONCLUSIONS: Patient-centered and careful statistical methodologies were used to construct the ATAQ-IPF version 1, an IPF-specific HRQL instrument. Simple summation scoring is used to derive individual domain scores as well as a total score. Results support the validity of the ATAQ-IPF, and future studies will build on that validity.

Rasch analysis of the Geriatric Depression Scale-Short Form.

PURPOSE: The purpose of this study was to examine scale dimensionality, reliability, invariance, targeting, continuity, cutoff scores, and diagnostic use of the Geriatric Depression Scale-Short Form (GDS-SF) over time with a sample of 177 English-speaking U.S. elders. DESIGN AND METHODS: An item response theory, Rasch analysis, was conducted with data from a larger study that implemented 3 interventions and collected data at 3 time points (prior to intervention, after intervention, and a year following the end of intervention). RESULTS: A unidimensional structure was found in this study to adequately fit the data. There appears to be significant differential item functioning, with up to one third of the items indicating that the items have different meanings for different groups of participants. As a screening tool, the GDS-SF is more likely to discriminate between older adults who have a "moderate" level of depression than between those with mild depression and no diagnosed depression. IMPLICATIONS: We would recommend that the GDS-SF not be used as the sole method of screening for depression but incorporated into other clinical knowledge related to the geriatric patient in question, given that not all items are equally functional. The GDS-SF may be less effective as a screening tool but could be better used to detect a change in moderate levels of depression. Clinicians may also benefit by identifying person responses that misfit. If an individual provides responses that are atypical, the person might be referred to provide a more in-depth assessment of mental health status.

Pilot study of the Sensory Over-Responsivity Scales: assessment and inventory.

This article describes 3 stages of construction of the Sensory Over-Responsivity (SensOR) Scales: instrument development, reliability and validity analyses, and cross-validation on a new sample. The SensOR Scales include the SensOR Assessment, an examiner-administered performance evaluation, and the SensOR Inventory, a caregiver self-rating scale. Both scales measure sensory overresponsivity in 7 sensory domains. Data were collected from 2 samples consisting of participants who were typically developing (ns = 60 and 44, respectively) and participants with sensory overresponsivity (ns = 65 and 48, respectively), ages 3 to 55. In developing the research edition, items on the pilot version were reviewed for their internal consistency reliability, discriminant validity, and construct validity. Data from both samples on the research edition revealed high internal consistency reliability for domains and the total test and significant discrimination between the overresponsive and the typically responsive groups (p < .05). The preliminary psychometric integrity of the scales, along with continued research efforts, is an important contribution to evidence-based practice.

Strengthening the late-life care process: effects of two forms of a care-receiver efficacy intervention.

PURPOSE: The primary goal of the Care-Receiver Efficacy Intervention (CREI) was to increase the capacity of cognitively able elderly care receivers to effectively manage their own care and optimize relationships with caregivers. To accomplish this, two forms of the CREI were created: an individual and a small-group form. The purpose of this study was to evaluate outcomes of these two CREI forms when compared to a case management approach. DESIGN AND METHODS: Utilizing a quasi-experimental design, between January 2002 and August 2004 we collected data from 177 elders at three time points: pretest, 2 months following the last session, and 12 months following the last session. The Care-Receiver Efficacy Scale and the Philadelphia Geriatric Center Morale Scale-Revised were the outcome measures. RESULTS: We found significant effects favoring the CREI for relationship with caregivers, self-care strategies, loneliness, and quality of life. Effects were strongest for the small-group form of the CREI. Overall, the care receivers in both forms of the CREI showed improved self-performance, with small-group CREI participants showing remarkable improvement related to quality of life. IMPLICATIONS: The results of this research suggest that care receiver intervention can be effective in improving the care process.

Coping with late-life challenges: Development and validation of the care-receiver efficacy scale.

PURPOSE: Measures are lacking that address the challenges that people think they face in their roles as elderly care receivers. However, the development of a sense of efficacy in this role by mentally competent care receivers is critical to successful partnerships between caregivers and care receivers. The purpose of this article is to report the development and psychometric analysis of the Care-Receiver Efficacy Scale (CRES). DESIGN AND METHODS: Content validity, internal consistency reliability, factor structure, and convergent validity were assessed through a pilot study, expert review, and field administration with 177 participants. RESULTS: Results suggest that the CRES comprises five subscales, with strong reliability evidenced for three subscales but marginal reliability for the remaining two. Strong support was found for content validity from expert review and moderate support from the relationship between empirical and expert judgment of item location. Support for validity also was found from correlation with the Geriatric Depression Scale-Short Form and the Philadelphia Geriatric Center Morale Scale. IMPLICATIONS: The CRES may be useful as an outcome measure for psycho-socio-behavioral interventions aimed at increasing the capacity of care receivers to direct and improve their own care. Future measure revision and validation are important to optimize its utility.

Item grouping effects on invariance of attitude items.

The purpose of this study was to evaluate the effects of item grouping on local independence and item invariance, the characteristics of items scaled under the Rasch model that make them sample-free. Item fit and calibration for attitude items presented in a grouped versus random order were examined. It was hypothesized that grouping items to facilitate interpretation central to a construct may result in a failure of invariance. Data were 107 responses to a 40-item mail survey of teachers' opinions about the Ontario Ministry's grade 9 literacy test. Effects of grouping and item phrasing on invariance were found. Results, however, generally support the use of grouping of items to provide a higher person separation, and potentially higher quality data.