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Review of scales – Propositions for COURAGE study.
Review of scales –
Propositions for
COURAGE study.
General Health Status and Quality of Life
For review there were chosen generic scales, shorter than 50 items not to
provoke huge growth of questionnaire, and longer than 15 items, what should
provide acceptable coverage of facets by items and dimensions measured by
the scale (content validity). Scales were also intended to measure particular
dimensions of health and QoL, rather than yielding unidimensional score.
For those reasons, at the pre-review stage were rejected: The Physical and
Mental Impairment of Function Evaluation, The Functional Assessment
Inventory, The Quality of Life Index, The COOP Charts for Primary Care
Practises, Single-Item Health Indicators, The Functional Status Questionnaire,
The OARS Multidimensional Functional Assessment Questionnaire, The
Comprehensive Assessment and Referral Evaluation, The Multilevel
Assessment Instrument, The Self-Evaluation of life Function scale, McMaster
Health Index Questionnaire, The Sickness Impact Profile, The Disability and
Distress Scale, The Quality of Well–Being Scale, The Health Utilities Index.
General Health Status and Quality of LifeDimensions DUKE Health
Profile
Nottingham
Health Profile
SF-36 WHOQOL
Bref
Number of items 17 38 36 26
physical health * * * *
mental health * * *
social health * * * *
general health *
perceived health * *
self-esteem *
anxiety, depression #
level of independence *
spirituality *
environment *
pain * * *
Sleep *
emotional reactions *
energy level * *
role limitation due to physical problems *
role limitation due to emotional problems *
Time frame – last: week now 4 week 4 week* present, # additional measure combined of items included in other dimensions
General Health Status and Quality of Life
DUKE Nottingham
Health
Profile
SF-36 WHOQOL
Bref
Internal consistency 0,55-0,78 0,62-0,82 0,68-0,96 0,66-0,85
Test-retest 0,50-0,78 0,75-0,88 0,60-0,90 0,64-0,79
Reliability
DUKE
• High correlations with DUKE UNC Health profile
• Moderate to high correlations with Sickness Impact Profile
• Moderate to high correlations of mental health subscales with Zung depression scales
• High validity in terms of between groups differences
• High predictive validity
• Less vulnerability on floor or ceiling effect than Nottingham Health Profile or COOP charts.
General Health Status and Quality of Life
NHP
• high correlations with McGill Pain Questionnaire and General
Health Questionnaire
• moderate to high correlations with SF-36
• high validity in terms of between groups differences (groups of
patients, different treatment stages)
• high predictive validity
• vulnerability on ceiling effect and bad distinction between levels of
good health.
General Health Status and Quality of Life
SF-36
• high correlations with sickness impact profile
• high validity in terms of between groups differences: types and levels of disease,
• high predictive validity
• physical dimensions more sensitive to change than psychological ones,
• vulnerable for floor or ceiling effects in short subscales (2-4 items).
WHOQOL Bref
• high correlations with WHOQOL Full
• high validity in terms of between groups differences (groups of
patients)
• Most universal measure of HRQoL: breadth of covered dimensions
(McDOwell 2006)
Social Support
Social Support Questionnaire
Covers availability and satisfaction with support in domains such like:
appraisal and emotional support, at less extent instrumental and practical
support (27 items)
Social Relationship Scale
In 4 domains of problems : work related events, changes in financial situation,
personal health events, society; there are assessed indicators of:
• size of network: number of persons included by respondent into
consideration is accounted
• quality of the network: average of helpfulness ratings
• degree of reciprocity: number of persons who come of respondents to discuss
problems
Social Support
DUKE UNC Functional Social Support Questionnaire
Covers persons satisfaction with functional and affective support
(8 items)
DUKE Social Support and Stress Scale
Rates family and nonfamily relationships in terms of amount of
support they provide and stress they cause (24 items).
MOS Social Support Survey
Covers frequency of: emotional and informational support,
tangible support, positive social interactions and affection (20
items)
Social Support
SRS SSQ MOS SSS DUFSS DUSOCS
Internal consistency --- 0,94-0,97 0,91-0,96 0,80-0,85 0,53-0,70
Test-retest 0,54-0,99 0,83-0,90 0,72-0,76 0,50-0,77 0,40-0,76
Reliability
Validity
SRS
• high validity in terms of between groups differences (groups of
persons with different extent of problems)
SSQ
• moderate criterion validity in terms of between groups differences
(groups of persons with different extent of problems)
Social Support
MOS SSS
• Moderate to high correlations with loneliness, family functioning and
mental health,
DUFSS
• Low to moderate convergent validity
• Low correlations with other social measures arise concerns to the
latent variable measured by scale
DUSOCS
• Moderate to high convergent validity with Family Strength Measure,
• Results inconsistent as concerns validity of family and non family
measures
• High predictive validity of family stress score
Social Support & Social Interactions
SSL12-I
Covers everyday support, support in problem situations, and
esteem support (12 items)
Interview Schedule for Social interaction
Assessment of availability and supportive quality of social
relationships in four scores: availability of attachments,
adequacy of attachments, availability of social interaction,
adequacy of social interactions (53 items, 12 item version for
survey use available )
Social Support
ISSI SSL12-I
Internal consistency 0,67-0,79 0,70-0,72
Test-retest 0,66-0,88 ---
Reliability
Validity
ISSI
• high validity in terms of discrimination between groups differences
with different social adjustment, as well as with characteristics of
family network
• Moderate correlations with GHQ-30
• 12-item version for survey use available
SSL12-I
• Moderate to high correlations with loneliness
Psychological Well-being
The Health Opinion Survey: developed as psychological screening test
for adults in rural communities to identify psychoneurotic and related
types of disorder – was used in epidemiological studies for estimating
need for psychiatric services and in evaluating their impact. Consists of
20 item reflecting to mostly to somatic symptoms.
The Twenty-Two Item Screening Score for Psychiatric Symptoms: a
method to provide rough identification of where people lie on a
continuum of impairment in life functioning due to very common types
of psychiatric symptoms. The scale is intended to identify mental
disorder but not to specify its type and degree. Items reflect
psychological symptoms, psychophysiological and physical.
The Affect Balance Scale: 10 items developed to identificate the positive
and negative psychological reaction of peoples in general population to
events in their daily lives. Does not detects any psychological disorders.
The Positive And Negative Affect Scale: a brief measure (10 items) of
two facets of mood: positive and negative affects.
Psychological Well-being
Life Satisfaction Index: 20 items covering general feelings of well-being
among older people, scale based on concept of life satisfaction measures
zest (as opposed to apathy), resolution and fortitude, congruence
between desired and achieved goals, positive self-concept and mood
tone.
The Philadelphia Geriatric Center Morale Scale: designed to measure 3
dimensions of emotional adjustment in people aged over 70.
The general Well-being Schedule: a brief (18 items) broad ranging
indicator of subjective feelings and distress for use in community
surveys, includes 6 dimensions: positive well-being, self-control, vitality,
anxiety, depression, general health.
RAND Mental Health Inventory: 38 item scale, developed for use in
population survey, based on 4 factor structure of well-being: anxiety,
depression, loss of behavioral/emotional control and positive affects,
with additional scale of emotional ties.
Psychological Well-being
Health Perception Questionnaire: self report - 33 item -
instrument that records perception of past, present and future health,
resistance to illness and attitudes toward sickness: resistance to illness,
health concerns and sickness orientation. Six item not used in
subscales.
General Health Questionnaire : 60-item self-administered
screening instrument for detection of diagnosable psychiatric
disorders.
Psychological Well-being
22ISSPS ABS PANAS LSI A
Internal consistency 0,77 0,55-0,73 0,83-0,93 0,80
Test-retest 0,88 >0,86 0,39-0,71 >0,80
Reliability
GWS RAND MHI HPQ GHQ
Internal consistency >0,7 0,83-0,92 0,53-0,91
Test-retest 0,68-0,85 0,56-0,63 0,55-0,67
22ISSPS
• high discriminant validity validity in terms of between psychiatric
patients and non-patients
Validity
Psychological Well-being
Validity
ABS
• High agreement with other self-reported indexes of well-being
• Discriminant validity inferred by socioeconomic status,
• Moderate agreement with social participation satisfaction with social life,
and happiness
• Lack of association of results with age
PANAS
• High correlation of negative aspect scale with Beck Depression Inventory
and neuroticism score, Hopkins Symptoms Checklist, Spielberger’s State
Anxiety scale
• High correlation of positive aspect scale with extraversion score
• Moderate negative correlation of positive aspect scale with Depression
Anxiety Stress Scale and Spielberger’s State Anxiety scale
• High convergent correlations with Mental Health Inventory
LSI A
• Number of measured factors differs in particular studies from
2 to 5.
• High to moderate correlations with other life satisfaction
indexes
• Moderate positive correlation with PANAS positive affect score
and high negative with PANAS negative affect score
• Positive correlation with socioeconomic status, social
participation,
GWS
• Empirical data confirm 3 factor structure with high
correlation, what supports use of unidimensional score,
• Moderate to high correlation s with depression scales
• Moderate correlation s with stress indexes
• High correlations with GHQ and State-Trait anxiety inventory
Psychological Well-being
HPQ
• Moderate to high correlations with criterion variables,
• Higher correlation with health status variables than with
health behaviours variables
• Negative association between health perception and age
Psychological Well-being
RAND MHI
• Low correlations with life event scale
• moderate correlations with life satisfaction indexes
• Moderate to high correlation with emotional problems
indicators
• High convergent correlation with PANAS
Functional status
The Pulses Profile: designed to evaluate by health professional
functional independence in ADLs of chronically ill and elderly
institutionalized populations– 5 items.
The Bartel Index: intended to measure by health professional
functional independence of rehabilitation patients – 10 items.
The Index of Independence in Activities in Daily Living: developed to
measure (originally by health professional) the physical functioning od
elderly and chronically ill patients – 6 items .
The physical self-maintenance scale: disability measure for use in
planning and evaluating treatment for elderly people living in
community or institutions. Includes ADL and IADL scales (resulting in
14 items but with different set of answers for particular items), self-
administered version available.
The Lambeth Disability Screening Questionnaire: designed for postal
use screening tool for physical disability in adults living in community
22 items concerning ADL, IADL functions, as well as communicating.
Functional status
The OECD Long-Term Disability Questionnaire: instrument
summarizing the impact of ill health on essential daily activities: 16
items reflecting vision, hearing, speaking, moving, feeding and some
IADL functions.
The Functional Status Rating System: measure estimating assistance
required by rehabilitation patients in terms of ADL functioning, ability
to communicate and social adjustment.
The Functional Status Index : designed to assess, by the interviewer,
the functional status of adult patients with arthritis, as evaluative tool
for measuring degree of dependence pain and difficulties experienced
in performing ADLs, IADLs and social activities.
The Functional Activites Questionaire: a screening tool (10 items) for
assessing independence in ADLs in community studies of normal
agieng and in mild dementia.
The Groningen Activity Restriction Scale: 18 –item instrument
measuring independence in ADL and IADL functions, characterized by
higher psychometrics properties than separated scales of ADL and
IADL.
Loneliness
De Jong Gierveld Loneliness Scale: 11-item scale, consisting of 2
dimensions: social loneliness – 5 positively worded items - and
emotional loneliness – 6 negatively worded items. Since dimensions are
correlated unidimensional score use is allowed.
The UCLA Loneliness Scale: 20-item scale (10 positively and 10
negatively worded) summed into single score. 10-item measure
available.
The Loneliness Rating Scale: 40-item scale, measuring 4 dimension (10-
item each): depletion, isolation, agitation, dejection.
Loneliness
The Emotional-Social Loneliness Inventory: scale comprising of
15 pairs of statements concerning isolation and loneliness, which
are divided into social and emotional dimensions.
The Social and Emotional Loneliness Scale for Adults: 15-item
instrument, divided into family, romantic and social dimensions.
The Differential Loneliness Scale: 60-item scale, consisting of 4
dimensions: loneliness in groups, romantic-sexual loneliness,
friendship loneliness and family loneliness, measured in term of
quality and quantity of interactions.
Loneliness
De Jong
Gierveld
UCLA LRS
Internal consistency 0,80-0,90 >0,88 0,82-0,89
Test-retest --- 0,73 ---
Reliability
ESLI SELSA DLS
Internal consistency 0,82-0,86 0,89-0,96 0,90-0,92
Test-retest 0,80 --- 0,85-0,97
Loneliness
De Jong Gierveld scale
• Positive items subscale correlated strongly with 7-item subscale of
UCLA, and moderately with direct measures of loneliness
• Negative subscale of DJG correlated with direct measures of
loneliness
Validity
UCLA scale
• High positive correlation with NYU Loneliness scale
• High negative correlation with measures of social support
• Moderate correlations with extraversion (negative) and neuroticism
(positive) dimension of Eisenck Personality Inventory
• Concerns to unidimensionality of the scale
Loneliness
LRS
• Two of four factors seem to measure the same latent variables as
some depression scale: depletion and lowness of spirit,
• One factor called agitation measures feelings which are closer to
anxiety.
ESLI
• High discriminative validity between group therapy patients and
other study participants
• Factor structure has low replicability between studies
Loneliness
DLS
• High concurrent validity against several criteria.
SELSA
• High convergent validity with analogous subscales of Differential
Loneliness Scale , Wittenberg Emotional subscale and Russell
Emotional subscale and subscales of de Jong-Gierveld 28-item
loneliness scales.
• One factor called agitation measures feelings which are closer to
anxiety than loneliness.
Abuse and neglect
Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST): 15 item
questionnaire. Items were determined to measure 3 dimensions: violation of
personal rights or direct abuse, characteristics of the vurnerability to abuse,
characteristics of a potentially abusive situation. The H-S/EAST should not be
used to predict specific types of abuse or neglect. Adequate validity of H-
S/EAST was reported for small clinical populations. Cronbach alpha
coefficients <0,30. Discriminant function analysis correctly classifies 68% of
cases.
The Conflict Tactics Scale (CTS): 39-item instrument for identifying domestic
violence by measuring 5 dimensions: physical assault, injury, psychological
aggression, sexual coercion, negotiation. There are two main versions of CTS:
the CTS2 for measuring violence against a partner and CTSPS for measuring
maltreatment of a child by parents. The CTS consists of a list of behaviours
directed toward a partner or a child, and measures the behaviour of both the
respondent and the respondent’s partner. Test-retest correlations for CTS2
from 0,49 to 0,90. Cronbach alpha coefficients from 0,34 to 0.94.
Indicators of Abuse: 40-item checklist, requires in-depth interview; setting not
specified. In terms of discriminant function analysis scale correctly classified
over 80% of „likely abuse” cases and almost 100% „likely non-abuse” cases (as
classified by specially trained professionals) supporting high criterion validity.
Moderate correlations with Caregiver Abuse Screen and Ryden Aggression
Scale. Cronbach alpha coefficients >0.9.
Vulnerability to Abuse Screening Scale: 12 item self-report measure with four
factors (vulnerability, dependence, dejection, coercion). It consists of 10 item
from H-S/EAST and 2 additional items. High correlation of vulnerability score
with acute recent symptoms and measures of stress. High correlation of
dejection score with stress about relationships and conflict with children. High
negative correlation of coercion score with being able to depend on others.
Cronbach alpha coefficients from 0,31 to 0.74.
Abuse and neglect
