Utilidad de la evaluación online en Inmunología / No disponible

No disponible

[The validity and reliability of the general self-efficacy scale-Turkish form]. / Genel Özyeterlilik Ölçegi Türkçe Formunun Geçerlilik ve Güvenilirlik Çalismasi

OBJECTIVE: Self-efficacy, which is a basic construct in social cognitive theory, has been defined as one's belief in his/her ability to start, continue, and complete an action in a manner that has an impact on his/her environment. This study aimed to investigate the psychometric properties of the General Self-Efficacy Scale-Turkish Form. METHOD: The General Self-Efficacy Scale-Turkish Form was administered to 895 individuals ?18 years of age that had at least 5 years of education. Exploratory factor analysis, criterion validity testing (using the Beck Depression Scale, Spielberger Trait Anxiety Inventory, Locus of Control Scale, Learned Resourcefulness Scale, and Coopersmith Self Esteem Inventory), internal consistency analysis, and test-retest reliability analysis were performed. RESULTS: The 3-factor structure of the scale explained 41.5% of the observed variance. Correlations between the General Self-Efficacy Scale-Turkish Form and the other measures were statistically significant. The Cronbach's alpha coefficient for the entire scale was 0.80 and the test-retest reliability coefficient estimated from data for 236 individuals that were contacted for follow-up was 0.69. CONCLUSION: The General Self-Efficacy Scale-Turkish Form is a valid and reliable instrument for the assessment of general self-efficacy in individuals ?18 years of age with at least 5 years of education.

Dialogue study. Evaluación de la calidad de vida y de la piel periestomal del paciente ostomizado con el nuevo dispositivo SenSura / Dialogue study. To evaluate the quality of life and peristomal skin ostomy patient with the new device Sensura

En el año 2006, Coloplast comercializó en distintos países europeos un nuevo dispositivo para ostomías llamado SenSura. El presente informe de la investigación clínica incluye exclusivamente los resultados de la subpoblación incluida en España, como parte de un estudio internacional, en el que participaron numerosos países como Dinamarca, Estados Unidos, Canadá, Australia, Polonia, Países Bajos, Francia, Eslovaquia, Alemania, Reino Unido, Italia, Islandia, Japón, República Checa, Portugal, España, Corea del Sur y Argentina. Objetivos y variables de estudio. El propósito principal es evaluar la experiencia práctica con este dispositivo, en condiciones normales de uso, con especial atención al estado de la piel y a la calidad de vida. El objetivo principal es la evaluación de la calidad de vida a través del Cuestionario de Calidad de Vida llamado «Stoma QoL». En cuanto a los objetivos secundarios encontramos el estudio de la correlación entre calidad de vida y el estado de la piel periestomal. Otros son la evaluación del dispositivo utilizado habitualmente por el paciente en el momento de entrar en el estudio, así como el dispositivo SenSura y el registro de acontecimientos adversos a lo largo de todo el proceso. Diseño del estudio. Se trata de un estudio abierto, longitudinal, internacional, no comparativo y post-comercialización. El período de estudio para cada paciente es de seis a ocho semanas +/– cuatro días, incluyendo una visita inicial y otra final. La población del estudio consiste en personas portadoras de una colostomía o una ileostomía. Metodología. En España participaron un total de 10 centros, para un total de 131 pacientes. En el presente informe únicamente se presentan resultados correspondientes a nueve centros y un total de 123 pacientes. El motivo es que el último centro comenzó el estudio con un retraso considerable. Los pacientes correspondientes a éste, junto con el resto de centros en España, serán incluidos en el próximo informe de investigación clínica internacional. Herramientas de medición. Stoma-QoL (Cuestionario de calidad de vida para personas ostomizadas). OST (Ostomy Skin Tool) Instrumento para la evaluación de la piel periestomal. Resultados. En cuanto a la calidad de vida, en la visita basal nos encontramos con una media de 59 sobre 100 (SD= 8,8), mientras que en la visita final del estudio, la puntuación media obtenida ha sido de 59,6 sobre 100 (SD= 9,3), aunque los resultados definitivos con respecto a esta variable se presentarán en el informe global, dado que no se ha alcanzado población suficiente en España para el análisis de esta variable. El estudio reveló una mejora significativa en el estado de la piel periestomal al final del mismo, medida a través de la herramienta OST (Ostomy Skin Tool). En cuanto a la evaluación del dispositivo SenSura, se registró una mejora significativa con respecto a la aparición de fugas de efluente, así como del resto de ítems evaluados en relación con el dispositivo(AU)

In 2006, Coloplast launched in several European countries a new device for ostomy care called Sensura. This clinical research report includes only the results of the subpopulation included in Spain as a part of an international study, involving many countries such as Denmark, United States, Canada, Australia, Poland, Netherlands, France, Slovakia, Germany, UK, Italy, Iceland, Japan, Czech Republic, Portugal, South Korea and Argentina. Objectives and study variables. The main purpose of the study is to evaluate the experience with Sensura, under normal conditions of use, with special attention to skin condition and quality of life. The main objective of the study is to evaluate the quality of life, through Quality of Life Questionnaire called «Stoma QoL». A secondary objective, is to study the correlation between quality of life and the peristomal skin condition. Other Secondary objectives include the evaluation of the patient's current device at the time of entering the study, and by the other hand, the device Sensura and safety evaluation throughout the study. Design study. The study was designed as an open label, non-comparative, multi-national Post Market study. The study period for each patient is 6 to 8 weeks +/– 4 days, which includes an initial visit and a final visit. The study population included people who carry a colostomy or ileostomy. Methodology. Regarding Spain, a total of 10 sites participated and included a total of 131 patients. This report only presents results for nine sites and a total of 123 patients. The reason is that the last participating site began the study with a considerable delay. The remaining subjects included in this site together with the other centers in Spain and the other participating countries will be included in the final international report, that will present the overall results. Measurement tools. Stoma-QoL (Quality of Life Questionnaire for people with an ostomy). OST (Ostomy Skin Tool) instrument for the assessment of peristomal skin. Results. As for the quality of life, at baseline we found a mean of 59 out of 100 (SD = 8.8), while the final study visit, mean score was 59.6 out of 100 (SD = 9.3), although the final results on this variable will be presented in the global report, since since it has not reached sufficient population in Spain for the analysis of this variable. The study revealed a significant improvement in the peristomal skin condition at the end of the study, measured by the tool OST (Ostomy Skin Tool). Regarding the evaluation of the SenSura device, there was a significant improvement related to the appearance of leakage of effluent, as well as other items evaluated in relation with the device(AU)

Resultados de una aplicación desarrollada para la autoevaluación de las clases prácticas de Parasitología en la Licenciatura de Farmacia / Results of a computer application for self-evaluation of the practical classes of Parasitology in the Pharmacy Degree

contiene información e imágenes de parásitos obtenidas de las mismas preparaciones que observan enlas clases prácticas. Con ella pueden repasar y autoevaluar los conocimientos adquiridos. Para evaluarel proyecto, se ha permitido el acceso ilimitado a la aplicación a 74 alumnos, durante los 9 días en querealizaron sus prácticas. Las calificaciones obtenidas han sido comparadas con un grupo control de 75alumnos que realizó las prácticas el curso anterior en fechas coincidentes con las del grupo de estetrabajo y con los mismos profesores. La comparación de las calificaciones arroja un incremento mediode 0,7 puntos (sobre 10). Estudiando estos datos según rangos de puntuación, se observa que el grupoexperimental ha disminuido el porcentaje de suspensos (2,50%), incrementándose 9,95% los alumnoscon calificación ≥9,0 (sobre 10). Estos alumnos han contestado una encuesta anónima en la que nosdan su opinión acerca de la usabilidad, organización, diseño y calidad de la aplicación, suficiencia dela información aportada, utilidad de la autoevaluación, mejora del aprendizaje y resultados obtenidosen la autoevalución de la aplicación, así como su opinión sobre posibles mejoras de la misma,valorando entre 1 (pésimo) y 5 (óptimo). La encuesta, respondida por 50 alumnos de 74, arrojó unamedia global de 4,28 sobre 5. El alumnado expresó su satisfacción por contar con esta herramienta deapoyo a las prácticas(AU)

A computer application for students in "Parasitology (2nd year of Pharmacy) that contains informationand pictures of the parasites obtained from the same preparations that observed in practical classes hasbeen developed. With this computer tool, the students can review and self-evaluation their learning.For the evaluation of the project, a 74 students group was allowed unlimited access to the computerapplication during the 9 days that did their practices. The scores obtained have been compared with acontrol group of 75 students who did the practice the previous year on dates coinciding with the groupof this study and with the same teachers. The comparison of the ratings shows an average increase of0.7 points (on 10). Studying these data according to score ranges, it appears that the experimentalgroup decreased the failure rate (2.50%), increasing 9.95% rating students with ≥ 9.0 (on 10). Thesestudents have answered an anonymous survey in which they give their opinion about the usability,organization, design and quality of implementation, fitness of provided information, the utility of selfevaluation,improvement of learning and evaluation their results in the implementation as well as theirviews on possible improvements to it, from 1 (very poor) to 5 (excellent). The survey was answeredby 50 students from 74, giving an overall average of 4.28 points on 5. The students expressed theirsatisfaction with this computer tool available to support practices(AU)

Panorama educativo Europeo para la formación de los toxicólogos forenses / European educational overview for the training for forensics toxicologists

La singularidad de los Laboratorios Forenses así como la trascendencia de los resultados que emiten, requiere una labor especializada para la que es indispensable que los recursos humanos e instrumentales sean los adecuados y garanticen su continuidad y adecuación en el tiempo. La formación básica en Toxicología, que comparten diferentes licenciaturas, han adaptado los planes docentes a la nueva concepción de la docencia en el Espacio Europeo de Educación Superior con el objetivo en el pregrado de introducir al universitario en los aspectos más importantes de la Toxicología siguiendo en el postgrado las ramas especificas entre las que se encuentra la Toxicología forense (AU)

Educational overview for the training for forensics toxicologists. The uniqueness of Forensic Laboratories and the significance of their results require a specialized task for which it is essential that human and material resources are adequate and also capable of ensuring their continuity and adaptation over time. Basic training in Toxicology, it is shared by different degrees, have adapted teaching plans to the new concept of teaching in the European Higher Education Area with the objective of introducing the under graduate degree in toxicology ́s most important aspects. Postgraduate studies are focused on more specific issues such as forensic Toxicology (AU)

Approaches to professional behaviour assessment: tools in the professionalism toolbox.

There is general agreement that professionalism and professional behaviour should be (formatively and summatively) assessed, but consensus on how this should be done is still lacking. After discussing some of the remaining issues and questions regarding professionalism assessment, this article discusses the importance of qualitative comments to the assessment of professional behaviour, focuses on the currently most frequently used tools, as well as stresses the need for triangulation (combining) of these tools.

A re-examination of performance dimensions using data from the National Public Health Performance Standards Program V.1 instrument.

As part of a study to compare health department organizational networks and performance, we examined dimensions of the National Local Public Health Performance Standards (NPHPS) Assessment instrument. Data from >450 health departments loaded into 4 factors that cut across essential public health services and were distinct from factors produced in prior analysis. Findings suggest that managing public health resources based solely on essential services may not achieve peak performance.

Método de implantación de una acción de mejora en el Servicio de Ginecología del Hospital Universitario Nuestra Sra. de Candelaria / No disponible

En el sector sanitario asistimos a un creciente número de experiencias de autoevaluación deacuerdo al modelo EFQM. Este trabajo muestra el proceso seguido en un hospital público de 900camas localizado en Tenerife, Islas Canarias, en la aplicación de los criterios del modelo EFQM y elproceso para dinamizar el centro donde una experiencia similar había fracasado 5 años antes.Material y métodos. Tras una autoevaluación con el modelo EFQM se identificaron un conjuntode puntos fuertes y áreas de mejora. De las 10 priorizadas, la selección de indicadores para evaluarel core business del centro fue la más destacada. Después de valorar diferentes alternativas, segúnlos criterios impacto, esfuerzo y resultados, se focalizó en los principales procesos del centro que cursarancon hospitalización. Dado que dos de esos procesos estaban vinculados al Servicio de Ginecología,se constituyó un grupo entre facultativos, enfermería, gestores y técnicos para la selección deindicadores de parto, cesárea e histerectomía.Resultados. Siguiendo los criterios de accesibilidad, adecuación, riesgo, eficiencia, satisfacción yefectividad, el equipo de trabajo seleccionó 14 indicadores para la evaluación de parto, cesárea e histerectomía.Conclusiones. La aplicación del modelo EFQM requiere realizar cambios previos en los serviciosde soporte a la gestión. Nos permitió encontrar un foro común, donde facultativos, enfermería,gestores y técnicos pudieron encontrar no sólo nuevos indicadores, sino una nueva forma de ver lascosas para trabajar con un método

An increasing number of self-evaluation experiences developed in the health care sector in Spainwith the application of the European Foundation for Quality Management Excellence Model –EFQMis being seen.This work shows the process of applying the EFQM criteria to a 900 beds public hospitalin Tenerife, Canary Islands as well as the process to dynamize the hospital where a previous processin the same model had failed five years before.Methods. After a self-evaluation with the EFQM model, the organization identified a combinationof strong points and areas of improvement. A total of 10 areas of improvement were selectedto be carried out, that of the selection of indicators to evaluate “core business” of the site standingout the most.After evaluating the different alternatives, according to the criteria of impact, effortand results, focus was placed on the main processes with hospitalization of the site. Given thatthese processes belonged to the Gynecology Department of the hospital, a team formed by doctors,managers, nurses and technicians was formed to select the indicators for delivery, caesareanand hysterectomy.Results. According to accessibility, adequacy, risk, efficiency, satisfaction and effectivity, the workteam selected 14 indicators for evaluation of the caesarean, delivery and hysterectomy.Conclusions. Application of the European Foundation for Quality Management Excellence Modelrequires previous changes in the clinical management support. It allows us to find a common panelwhere doctors, nurses, managers and technicians not only can find new indicators but also a newpoint of view in order to work with a method

Shift analysis versus dichotomization of the modified Rankin scale outcome scores in the NINDS and ECASS-II trials.

BACKGROUND AND PURPOSE: The SAINT I trial that showed a significant benefit of the neuroprotectant NXY-059 used a novel outcome for acute ischemic stroke trials: a shift toward good functional outcome on the 7-category modified Rankin scale (mRS). METHODS: We used the Cochran-Mantel-Haenszel shift test to analyze the distribution of the 90-day mRS outcomes in the NINDS and ECASS-II databases and compared the results with a dichotomized mRS outcome by logistic regression (0 to 2 vs 3 to 6, or 0 to 1 vs 2 to 6). We also stratified each dataset based on National Institutes of Health Stroke Scale baseline severity. RESULTS: Each dataset showed a statistically significant shift in the 90-day mRS distributions favoring tissue plasminogen activator (odds ratio, 1.6 for NINDS, 1.3 for ECASS-II). For ECASS-II, larger shift effects appeared in National Institutes of Health Stroke Scale 0 to 6 and 16 to 40 strata. Similarly, the mRS 0 to 2 analysis but not mRS 0 to 1 found similar treatment effects in both datasets (odds ratio, 1.6 for NINDS, 1.5 for ECASS-II) and similar variations in the low and high strata in the ECASS-II trial. NINDS found no significant treatment effects across the strata. After removing the strata at the fringes, the shift test lost significance in both datasets. CONCLUSIONS: Tissue plasminogen activator causes a beneficial shift toward wellness on the mRS in both the NINDS and ECASS-II trials, and ECASS-II would have been a positive trial according to the shift approach. However, the shift effect is not global for all treated patients and does not outperform the dichotomized 0 to 2 outcome. Patients with mild and severe deficits also shifted favorably on the mRS in the ECASS-II trial.

Development and validation of a care process self-evaluation tool.

Clinical pathways are used as a method of organizing care processes. Although they are used worldwide, the concept remains unclear, with little understanding of what exactly is being implemented. A recent systematic review revealed that, although a tool exists to score the instrumental qualities of clinical pathways, no tools are available to assess how the clinical pathway influences the process of care. These tools are needed for a better understanding of the impact of clinical pathways on the length of hospital stay and patient outcomes. In this study, a Care Process Self-Evaluation Tool (CPSET), based on the clinical pathway concept, for assessing the organization of the process of care has been developed and tested. Qualitative and quantitative methods, involving 885 professionals and patients, were used in the development and validation. The CPSET is a valid and reliable 29-item instrument for assessing how the process of care is organized. The CPSET has five subscales: patient-focused organization, coordination of care, communication with patients and family, cooperation with primary care and monitoring/follow-up of the care process. The CPSET can be used in the audit and accreditation of care processes and will help managers and clinicians to understand better how care processes are organized.

Assessment of functional outcome in a national quality register for acute stroke: can simple self-reported items be transformed into the modified Rankin Scale?

BACKGROUND AND PURPOSE: To enable self-reporting of functional outcome in quality registers, the corresponding questions have to be easy to interpret. In scientific research, the modified Rankin Scale (mRS) is a standard assessment method. Such methods, with an outsider observer, are not feasible to use in quality registers. For several aspects, eg, comparisons between outcome in clinical studies and observational studies, we determined to see whether the functional outcome, as assessed in a quality register, can be transformed into mRS grades. METHODS: The agreement between self-reported functional outcome (including dependency, living situation, mobility, dressing and toileting) and mRS were analyzed using 555 stroke patients registered in Riks-Stroke, the Swedish quality register for acute stroke, during a 5-month period in 4 hospitals. The self-reported outcome and the mRS grades were concurrently assessed by a telephone interview performed by an experienced nurse 3 months after stroke. RESULTS: A translation using 5 of the questions from Riks-Stroke classified 76% of the patients to the correct mRS grade. The correlation between Riks-Stroke and mRS was 0.821 and Cohen's kappa (weighted) was 0.853. CONCLUSIONS: The study shows that self-reported functional outcome can be transformed into mRS grades with a high precision, making the translation useful for future comparative purposes in stroke outcome studies.

Evaluating a formal evidence-based clinical practice curriculum in a neurology residency program.

BACKGROUND: Since 1998, the University of Western Ontario Evidence-Based Neurology Programme has been fostering life-long self-teaching, self-evaluation, and promoting improvement of the care of neurological patients by teaching neurology residents to practice Evidence-Based Clinical Practice (EBCP). DESIGN/METHODS: Using a questionnaire/survey we evaluated participation during EBCP sessions and the applicability of EBCP to current and future clinical practice. Also, using a rating scale we investigated how likely our residents' and graduates' clinical practice has been influenced by the EBCP knowledge; and, if they were teaching these concepts to residents or medical students. The questionnaire was sent to all neurology residents and neurologists that graduated after implementation of the programme. RESULTS: All residents (100%) returned the survey/questionnaire, indicating that they attended the sessions consistently. Even though all respondents believed that the EBCP concepts were useful during their training, the concepts were infrequently utilized because of time constraints. On a scale of 1 to 10, they rated the influence to include EBCP concepts in their daily clinical practice as high (average: 6.8, S.D. 1.5). They all had frequent contact with medical students and non-neurology residents, but did not teach EBCP concepts to them on a consistent basis, because of time limitations. 10 (77%) out of 13 graduates returned the survey/questionnaire. They also believed the EBCP concepts were useful, but only used them when time allowed. They also rated the influence to include EBCP concepts in their daily clinical practice as high (mean 8.5, S.D. 1.2). Most graduates had frequent contact with trainees, but did not teach EBCP concepts to them on a consistent basis because of time constraints. Finally, all expressed the need to continue having this formal curriculum during residency. CONCLUSION/RELEVANCE: Although EBCP incorporated into the curriculum of a neurology residency programme increased neurologists and neurology trainees' confidence in knowledge of existing evidence, and reinforced the EBCP principles, these concepts were not used in daily clinical practice and were not taught to more junior trainees due to time constraints.

Criteria referenced student self-assesment in restorative dentistry.

The application of criteria referenced assessment has been previously reported, however, criteria referenced self-assessment has not yet been studied. The objective of this study was to develop and use clear and explicit criteria, linked to a level of competency and a score, as well as a checklist, for student self-assessment in Restorative Dentistry. A comparison of student self-assessment and supervisor-assessment was also undertaken to determine the validity and reliability of the criteria. Six levels of competency were adapted from the literature and a criterion was developed for each level of competency and used for student self-assessment of clinical procedures in Restorative Dentistry (BChD IV and BChD V). Each level of competency was given a score: U = Unqualified (0), NBQ = Not becoming Qualified (1), BQB = Becoming Qualified as a Beginner (2), BQL = Becoming Qualified as a Learner (3), Q = Qualified (4), E = Exceptional (5). The students used the criteria on the assessment form, to assess themselves accordingly (U, NBQ, BQB, BQL, Q, E) and this was compared to the supervisor assessment using the same criteria. The results were subjected to a Spearman Rank-Order Correlation test. The Spearman Correlation Coefficient for the BChD V group was 0.882 and 0.927 for the BChD IV group in the first semester and 0.923 for the BChD V group and 0.900 for the BChD IV group in the second semester. The results were highly significant (p< 0.05). There were no significant differences between student self-assessment and supervisor-assessment. The criteria referenced assessment system used to assess clinical competency in Restorative Dentistry is valid and reliable.

¡Preparándonos para la acreditación por la Agencia de Calidad Sanitaria de Andalucía! Autoevaluación de 5 hospitales de la Orden Hospitalaria San Juan de Dios, Provincia Bética / Preparation for accreditation by the Andalusian Health Care Quality Agency. Autoevaluation of 5 hospitals of San Juan de Dios religious order in the Betic Province (Spain)

Objetivo: Desde hace décadas, los centros de la Orden Hospitalaria San Juan de Dios se plantean objetivos y acciones encaminados a mejorar la calidad de la asistencia, aunque de manera poco sistematizada. Desde la Curia Provincial Bética, se plantea fomentar el desarrollo de sistemas de calidad en 5 centros sanitarios, que permitan "implantar una cultura de calidad entre los profesionales" y "optar a la acreditación por la Agencia de Calidad Sanitaria de Andalucía". Material y métodos: Se desarrollan 7 acciones: dirección y coordinación del plan de calidad desde la Curia Provincial; formación de los profesionales; creación de una estructura de calidad (un grupo central de calidad, 8 subgrupos por área temática y numerosos grupos de trabajo); documentación de apoyo; plan de implantación de procesos asistenciales integrados en cada centro; plan operativo para la autoevaluación del centro: agrupamiento de estándares; selección de los responsables de subgrupos; análisis de los estándares por subgrupo; planificación de las mejoras; implantación de los planes de mejora; evaluación; corrección y mejora, y solicitud de acreditación de nuestros centros por la Agencia. Resultados: Todos los centros han cumplido los objetivos propuestos o están en la planificación y/o implantación de los planes de mejora cuando se contacta con la Agencia. Conclusiones: La autoevaluación nos ha llevado a conocernos mejor mostrándonos nuestros puntos fuertes y áreas de mejora. El trabajo simultáneo en 5 centros ha permitido el reparto de tareas, un mayor conocimiento de la organización y una homogeneización de la asistencia entre los centros (AU)

El proceso de evaluación externa de los hospitales para la acreditación de la formación sanitaria especializada / The process of external evaluation of hospitals for accreditation of specialized healthcare training

El presente trabajo tiene por objeto analizar la metodología de evaluación externa de la acreditación para la formación sanitaria especializada en España, y revisar, a la par, las experiencias que en este sentido realizan las agencias de acreditación nacional e internacional. Debido al importante incremento cuantitativo en las evaluaciones efectuadas, es imprescindible que las actividades practicadas sean análogas y estén perfectamente delimitadas e identificadas mediante procedimientos uniformes, que posibiliten la consecución de resultados homogéneos en situaciones similares, integrados en un manual-guía del proceso, que incluya herramientas de verificación y fuentes de evidencia. Su utilización en la acreditación para la formación sanitaria especializada ha resultado primordial con el fin de conseguir la mayor eficacia y preservar el rigor en las actuaciones evaluadoras (AU)

The development of multi-level critical care competency statements for self-assessment by ICU nurses.

Multi-levelled critical care competency statements were developed based on the levels of novice to expert (Benner, 1984). These competency statements provide a framework for the development of knowledge and skills specific to critical care. The purpose of this tool is to guide personal development in critical care, facilitating the assessment of individual learning needs. Competency levels are attained through the completion of performance criteria. Multi-levelled competency statements define clear expectations for the new orientee, in addition to providing a framework for the advancement of the intermediate and experienced nurse.

Content and criterion validity evaluation of National Public Health Performance Standards measurement instruments.

OBJECTIVE: The Centers for Disease Control and Prevention's National Public Health Performance Standards Program (NPHPSP) has developed instruments to measure the performance of local and state public health departments on the 10 "Essential Services of Public Health," which have been tested in several states. This article is a report of the evaluation of the content and criterion validity of the local public health performance assessment instrument, and the content validity of the state public health performance assessment instrument. METHODS: Health department performance is measured using a set of indicators developed for the 10 Essential Services of Public Health and a model standard for each indicator. Content validity of each model standard in the local instrument was addressed by community partners along the following dimensions: the importance of each standard as a measure of the associated Essential Service, its completeness as a measure, and its reasonableness for achievement. All standards for each Essential Service were then judged in terms of their completeness in measuring performance in that service. Content validity of the state instrument was evaluated in a group interview of health department staff members from three states. Criterion validity of the local instrument was assessed for a sample of eight public health departments in Florida and six in New York by examining documentary evidence for selected responses. Criterion validity was also evaluated for a sample of Florida local public health departments and one Hawaii public health department by comparing state health department staffs' judgments of performance against the instrument score. RESULTS: Criterion validity was upheld for a summary performance score on the local instrument, but was not upheld for performance judgments on individual Essential Services. The NPHPSP standards based on the Essential Services have validity for measuring local public health system performance, according to community partners. The model standards are valid measures of state performance, according to state public health departments in three states. CONCLUSIONS: Within the scope of the validity evaluations completed, the NPHPSP state and local performance assessment instruments were found to be valid measures of public health performance.