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PubMed2004

Spatial-scale interaction in human stereoscopic vision in response to sustained and transient stimuli.

We investigated temporal properties of stereopsis at different spatial scales in dynamic random-dot stereograms (DRS) consisting of (i) the repeated presentation of two image pairs (i.e. sustained presentation) and (ii) single presentations of two image pairs (transient presentation). In dense stereograms perception of depth is possible if the levels of interocular correlation are above a certain threshold. Therefore, detection of correlation is an important step in stereopsis. Across different experiments, we varied the level of interocular correlation as a function of time by alternating correlated and un/anticorrelated random-dot stereograms. Also, we varied their spatial scale (coarse, fine and alternating between coarse and fine). The presence of stereopsis was examined using a forced-choice depth detection task. For both sustained and transient presentations of the stimuli, the results show that (i) stereopsis has similar temporal properties at coarse and fine spatial scales; (ii) interaction between spatial scales depends on their relative sizes. The results indicate a strong inhibitory influence of rivalry at a coarse scale on stereopsis at a fine scale, and just a weak inhibitory influence of rivalry at a fine scale on stereopsis at a coarse scale. This study provides experimental evidence for a hierarchical organisation of spatial scales in human stereoscopic vision based on neural interaction instead of vergence eye movements.

Adult↗
PubMed2003

Psychometric properties of the Activities-specific Balance Confidence Scale among individuals with a lower-limb amputation.

OBJECTIVE: To evaluate the internal consistency, test-retest reliability, and construct validity of the Activities-specific Balance Confidence (ABC) Scale among people who have a lower-limb amputation. DESIGN: Retest design. SETTING: A university-affiliated outpatient amputee clinic in Ontario. PARTICIPANTS: Two samples of individuals who have unilateral transtibial and transfemoral amputation. Sample 1 (n=54) was a consecutive and sample 2 (n=329) a convenience sample of all members of the clinic population. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Repeated application of the ABC Scale, a 16-item questionnaire that assesses confidence in performing various mobility-related tasks. Correlation to test hypothesized relationships between the ABC Scale and the 2-minute walk (2MWT) and the timed up-and-go (TUG) tests; and assessment of the ability of the ABC Scale to discriminate among groups based on amputation cause, amputation level, mobility device use, automatic stepping ability, wearing time, stair climbing ability, and walking distance. RESULTS: Test-retest reliability (intraclass correlation coefficient) of the ABC Scale was .91 (95% confidence interval [CI], .84-.95) with individual item test-retest coefficients ranging from .53 to .87. Internal consistency, measured by Cronbach alpha, was .95. Hypothesized associations with the 2MWT and TUG test were observed with correlations of .72 (95% CI, .56-.84) and -.70 (95% CI, -.82 to -.53), respectively. The ABC Scale discriminated between all groups except those based on amputation level. CONCLUSIONS: Balance confidence, as measured by the ABC Scale, is a construct that provides unique information potentially useful to clinicians who provide amputee rehabilitation. The ABC Scale is reliable, with strong support for validity. Study of the scale's responsiveness is recommended.

Accidental Falls↗
PubMed2001

Psychometric properties of the Beck Self-Esteem Scales.

The psychometric characteristics of the Beck Self-Esteem Scales (BSE) are described for 360 psychiatric outpatients. Patients rated their evaluative beliefs about themselves (Self Scale) and their beliefs about how others evaluate them (Other Scale). Both measures consist of 18 pairs of adjectives, e.g., lovable-unlovable, that are rated using a 10-point scale. The coefficient alphas for the Self Scale (0.94) and the Other Scale (0.95) indicated high internal consistency. Both scales were positively associated with other measures of self-esteem and negatively associated with measures of anxiety and depression. As predicted by the cognitive theory of depression, patients with a principal mood disorder scored significantly lower on the BSE than patients with a principal anxiety disorder. In addition, the mean scores for patients with major depression and dysthymia on the Self Scale were significantly lower than the mean scores for the Other Scale.

Adult↗
PubMed1997

Scaling effects in the perception of higher-order spatial correlations.

Human texture discrimination depends both on spatial-frequency content and on higher-order or multi-point correlations. Spatial-frequency discrimination exhibits a high degree of scale invariance over a range of several octaves, but the scaling behavior of sensitivity to higher-order correlation structure is unknown. We explored the scale dependence of texture discrimination for image ensembles which shared the same power spectrum, but differed in their higher-order correlations. Literally scaling the ensembles so that they occupy larger retinal regions results in discrimination performance that is largely independent of scale over a 3 octave range. Holding the display size constant and scaling the texture being sampled within the display over the same range produces performance that varies with scale appreciably. The ideal observer performance is computed, and the absolute efficiency is seen to be quite small, on the order of 10(-2)-10(-1). As the texture is scaled down, increasing the number of checks within the fixed display size, performance increases while the efficiency decreases. These dependencies remain when the stimulus onset asynchrony is increased from 50 to 500 msec. We created sets of textures which varied both in check number and correlation strength, for which ideal observer performance was equated. For the human observers, efficiency was significantly higher for textures with higher correlation strength, but fewer checks. These results are consistent with a model in which a fixed number of checks is processed in a scale-invariant manner, while the remainder of the display is processed much less efficiently.

Humans↗
PubMed2003

Age differences in postoperative pain are scale dependent: a comparison of measures of pain intensity and quality in younger and older surgical patients.

As the population ages, research into the assessment of postoperative pain in older patients is urgently needed. The reliability and validity of most pain scales for the assessment of acute postoperative pain in the elderly remain to be demonstrated. The present study reports the analysis of age-related patterns on three pain scales (McGill Pain Questionnaire, MPQ; Present Pain Intensity, PPI; and Visual Analog Scale, VAS) completed by younger (n=95, mean age=56.4+/-5.8 years) and older (n=105; mean age=66.8+/-2.7 years) men following radical prostatectomy. All patients received intravenous morphine via patient-controlled analgesia (PCA) throughout the study. On the first 2 postoperative days (POD), patients completed the pain scales and PCA opioid intake was recorded. An interaction was found between amount of opioid self-administered and POD. In both groups, less opioid was administered on POD 2 than POD 1, but the decrease over time was greater in younger than older men. On both PODs, older men self-administered less opioid than younger men. Age differences in pain were dependent on the pain scale used. Older men had significantly lower scores than younger men on the MPQ and PPI but there were no differences on the VAS. Several age differences in the psychometric properties of the scales were evident. On both PODs, the correlation between VAS and MPQ scores was significantly lower in the older than younger group. POD effect sizes did not differ between the scales or age groups suggesting that all three scales have comparable sensitivity within an age group. However, the different results between the scales for the effect of age suggests that the VAS is not sufficiently sensitive to detect age differences. Therefore, age differences in postoperative pain are better captured by verbal descriptions of pain qualities than non-verbal measures of intensity.

Age Factors↗
PubMed1997

Chronic rectal bleeding after high-dose conformal treatment of prostate cancer warrants modification of existing morbidity scales.

PURPOSE: Serious late morbidity (Grade 3/4) from the conformal treatment of prostate cancer has been reported in <1% to 6% of patients based on existing late gastrointestinal (GI) morbidity scales. None of the existing morbidity scales include our most frequently observed late GI complication, which is chronic rectal bleeding requiring multiple fulgerations. This communication documents the frequency of rectal bleeding requiring multiple fulgerations and illustrates the variation in reported late serious GI complication rates by the selection of morbidity scale. METHODS AND MATERIALS: Between May 1989 and December 1993, 352 patients with T1-T3 nonmetastatic prostate cancers were treated with our four-field conformal technique without special rectal blocking. This technique includes a 1-cm margin from the clinical target volume (CTV) to the planning target volume (PTV) in all directions. The median follow-up for these patients was 36 months (range 2-76), and the median center of prostate dose was 74 Gy (range 63-81). Three morbidity scales are assessed: the Radiation Therapy Oncology Group (RTOG), the Late Effects Normal Tissue Task Force (LENT), and our modification of the LENT (FC-LENT). This modification registers chronic rectal bleeding requiring at least one blood transfusion and/or more than two coagulations as a Grade 3 event. Estimates for Grade 3/4 late GI complication rates were determined using Kaplan-Meier methodology. The duration of severe symptoms with chronic rectal bleeding is measured from the first to the last transrectal coagulation. Latency is measured from the end of radiotherapy to surgery, first blood transfusion, or third coagulation procedure. RESULTS: Sixteen patients developed Grade 3/4 complications by one of the three morbidity scales. Two patients required surgery (colostomy or sigmoid resection), three required multiple blood transfusions, two required one or two blood transfusions, and nine required at least three coagulations. The median duration of bleeding for those patients requiring multiple procedures was 7 months (range 3-33) and the median latency was 22 months (range 9-40). The 5-year actuarial rate of Grade 3/4 complications by each scale are: RTOG 0.7%, LENT 2%, and FC-LENT 6%. The rate of chronic rectal bleeding increases with increasing dose and is low in patients treated with conventional techniques owing to lower doses. CONCLUSION: Chronic rectal bleeding requiring any blood transfusion(s) or multiple coagulation procedures is our most frequently observed complication. This complication appears late in follow-up and is present for a long duration. We believe this justifies the inclusion of chronic rectal bleeding requiring multiple coagulation procedures as a Grade 3 event in future morbidity scales. Our data illustrate that published Grade 3/4 morbidity rates are highly dependent on the morbidity scale selected, as our data show 0.7% RTOG, 2% LENT, and 6% FC-LENT. Obviously, a uniform scale is required that includes the newly recognized serious late effects associated with the conformal treatment of prostate cancer.

Aged↗
PubMedDate not supplied

A review of self-report scales for the assessment of functional limitation and disability of the shoulder.

A shoulder disorder affects a patient's overall quality of life. Self-report outcome measures can be used to assess the effects of shoulder dysfunction in terms of patients' functional limitations and disabilities. Selection of a shoulder-specific scale from the numerous scales available can be overwhelming. The purpose of this study was to review the self-report scales in current use for assessing the shoulder joint. A MEDLINE literature search was performed to locate scales appropriate to the assessment of function and disability of the shoulder. Only scales with established measurement properties were selected for review. Eleven scales were reviewed. Methodological and practical criteria were established to evaluate each scale. All scales met the minimal criteria, but not all scales were equal with regard to the criteria established for analysis.

Health Status Indicators↗
PubMed1999

The development of a maternal satisfaction scale for caesarean section.

Satisfaction has become an important outcome measure. The purpose of this study was to develop a valid, reliable maternal satisfaction scale for women undergoing caesarean section. After Research Ethics Board approval, each patient gave verbal consent. To ensure face validity, patients were interviewed before and after caesarean section. Interviewing until no new items were generated ensured content validity. A draft scale using a 7 point Likert scale was given to 115 patients. Items endorsed by less than 15% of patients were deleted. Item-total correlations, principal component and factor analysis were performed and items in factors with less than three items or complex loadings excluded. Correlating the new scale to a Visual Analogue Scale (VAS) for satisfaction assessed construct validity. Reliability, as measured by internal consistency, was tested using Cronbach's alpha. Twenty-five women were interviewed for item generation. Patients were both nulliparous and multiparous and all received regional anaesthesia for elective or non-emergent caesarean section. Six items of the 33 on the draft scale were excluded because of lack of endorsement. Five items were excluded after principal component and factor analysis and two after item-total correlations. The correlation between the scale total and the VAS was 0.48. Cronbach's alpha was 0.82 for the total scale. Maternal sense of control was the item most related to satisfaction. This scale provides more detailed information than a simple VAS. In the population studied, this tool was found to be a valid and reliable method for assessing maternal satisfaction in women undergoing non-emergent caesarean section.

Journal Article↗
PubMed1998

Liverpool Seizure Severity Scale revisited.

The purpose of the study was to examine the psychometric properties of the revised Liverpool Seizure Severity Scale. The scale has been adapted to increase its content validity and its potential for detecting change attributable to antiepileptic drug treatment. Ninety-seven patients completed the revised scale of which 32 completed it for both major and minor seizures. Reliability of the revised scale was conducted using assessment of internal consistency and test-retest. T-tests were conducted to assess the ability of patients to differentiate between major and minor seizures on scores of the seizure-severity scale. The psychometric properties of the scale were not adversely affected by either the increase in the number of items or the additional response scores. Patients completing the two scales of major and minor seizures were able to reliably differentiate between the two. We have attempted to improve the Liverpool Seizure Severity Scale in order to enhance its reliability, validity and sensitivity to change. The amendments we have made have not adversely affected its psychometric properties and we hope that it will make it more acceptable for use in clinical trials of new antiepileptic drug treatment. The revised scale is currently being applied to a number of clinical trials.

Adolescent↗
PubMed1996

Evaluation of Uterine Blood Loss with Bleeding and Visual Analog Scales

Measurements of uterine blood loss are important when comparing treatments for prolonged and excessive bleeding. We tested two methods of quantifying uterine blood loss in 110 women (age &gte;18 yrs) who were evaluated for uterine bleeding: a new bleeding scale and a visual analog scale. The bleeding scale measured the amount of flow from none to prolonged, excessive, and disabling. Data were analyzed by covariance, stepwise regression analysis, and factor analysis. Patient and physician visual analog scales were highly correlated. The patients rated themselves higher (worse) by 2 mm. The bleeding scale was more correlated with the physician scale than with the patient scale. The amount of flow most heavily weighted the visual scale, and clot size and activity most heavily weighted the bleeding scale. Duration of flow and anemia affected summary scores.

Journal Article↗
PubMed2003

Pain intensity assessment: a comparison of selected pain intensity scales for use in cognitively intact and cognitively impaired African American older adults.

The purpose of this study was to determine the reliability and validity of selected pain intensity scales including the Faces Pain Scale (FPS), the Verbal Description Scale, the Numeric Rating Scale, and the Iowa Pain Thermometer to assess pain in cognitively impaired minority older adults. A descriptive correlational design was used, and a convenience sample of 57 volunteers age 58 and older residing in the South was recruited for this study. The sample consisted of 8 males and 49 females with a mean age of 76. Fifty-nine percent of the sample completed an 11th grade education or less, and 59% completed high school or college. Seventy-seven percent (n = 44) of the sample scored 24 or less on the mental status exam, indicating some degree of cognitive impairment. The remaining 23% (n = 13) were cognitively intact. All of the participants were able to use each of the scales to rate their pain. Concurrent validity of the scales was supported with Spearman rank correlation coefficients ranging from.74 to.83 in the cognitively impaired group and.81 to.96 in the cognitively intact group. Test-retest reliability at a 2-week interval was acceptable in the cognitively intact group (Spearman rank correlations ranged from.73 to.83) and to a lesser degree in the cognitively impaired group (correlations ranged from.52 to.79). When asked about scale preference, both the cognitively impaired and the intact group indicated a preference for the FPS. Findings from this study suggest that cognitive impairment did not inhibit older minority participants' ability to use a variety of pain intensity scales. Additionally, options should be provided that address individual needs of older adults considering specific cognitive level and disability, education, gender, ethnicity, and cultural influences concerning perceptions of the various pain intensity scales.

Black or African American↗
PubMed2006

A new scale to assess the therapeutic relationship in community mental health care: STAR.

BACKGROUND: No instrument has been developed specifically for assessing the clinician-patient therapeutic relationship (TR) in community psychiatry. This study aimed to develop a measure of the TR with clinician and patient versions using psychometric principles for test construction. METHOD: A four-stage prospective study was undertaken, comprising qualitative semi-structured interviews about TRs with clinicians and patients and their assessment of nine established scales for their applicability to community care, administering an amalgamated scale of more than 100 items, followed by Principal Components Analysis (PCA) of these ratings for preliminary scale construction, test-retest reliability of the scale and administering the scale in a new sample to confirm its factorial structure. The sample consisted of patients with severe mental illness and a designated key worker in the care of 17 community mental health teams in England and Sweden. RESULTS: New items not covered by established scales were identified, including clinician helpfulness in accessing services, patient aggression and family interference. The new patient (STAR-P) and clinician scales (STAR-C) each have 12 items comprising three subscales: positive collaboration and positive clinician input in both versions, non-supportive clinician input in the patient version, and emotional difficulties in the clinician version. Test-retest reliability was r=0.76 for STAR-P and r=0.68 for STAR-C. The factorial structure of the new scale was confirmed with a good fit. CONCLUSIONS: STAR is a specifically developed, brief scale to assess TRs in community psychiatry with good psychometric properties and is suitable for use in research and routine care.

Adult↗
PubMed2006

A comprehensive self-consistent spectrophotometric acidity scale of neutral Brønsted acids in acetonitrile.

For the first time, the self-consistent spectrophotometric acidity scale of neutral Brønsted acids in acetonitrile (AN) spanning 24 orders of magnitude of acidities is reported. The scale ranges from pK(a) 3.7 to 28.1 in AN. The scale includes 93 acids that are interconnected by 203 relative acidity measurements (DeltapK(a) measurements) and contains compounds with gradually changing acidities, including representatives from all of the conventional families of OH (alcohols, phenols, carboxylic acids, sulfonic acids), NH (anilines, diphenylamines, disulfonimides), and CH acids (fluorenes, diphenylacetonitriles, phenylmalononitriles). The CH acids were particularly useful in constructing the scale because they do not undergo homo- or heteroconjugation processes and their acidities are rather insensitive to traces of water in the medium. The scale has been fully cross-validated: the relative acidity of any two acids on the scale can be found by combining at least two independent sets of DeltapK(a) measurements. The consistency standard deviation of the scale is 0.03 pK(a) units. Comparison of acidities in many different media has been carried out, and the structure-acidity relations are discussed. The large variety of the acids on the scale, its wide span, and the quality of the data make the scale a useful tool for further acidity studies in acetonitrile.

Journal Article↗
PubMed2005

Uncertainties in scaling factors for ab initio vibrational frequencies.

Vibrational frequencies determined from ab initio calculations are often scaled by empirical factors. An empirical scaling factor partially compensates for the errors arising from vibrational anharmonicity and incomplete treatment of electron correlation. These errors are not random but are systematic biases. We report scaling factors for 40 combinations of theory and basis set, intended for predicting the fundamental frequencies from computed harmonic frequencies. An empirical scaling factor carries uncertainty. We quantify and report, for the first time, the uncertainties associated with the scaling factors. The uncertainties are larger than generally acknowledged; the scaling factors have only two significant digits. For example, the scaling factor for HF/6-31G(d) is 0.8982 +/- 0.0230 (standard uncertainty). The uncertainties in the scaling factors lead to corresponding uncertainties in predicted vibrational frequencies. The proposed method for quantifying the uncertainties associated with scaling factors is based on the Guide to the Expression of Uncertainty in Measurement, published by the International Organization for Standardization (ISO). The data used are from the Computational Chemistry Comparison and Benchmark Database (CCCBDB), maintained by the National Institute of Standards and Technology, which includes more than 3939 independent vibrations for 358 molecules.

Journal Article↗
PubMed1999

A Kiswahili version of the SF-36 Health Survey for use in Tanzania: translation and tests of scaling assumptions.

The objective of the study was to translate and adapt the SF-36 Health Survey for use in Tanzania and to test the psychometric properties of the Kiswahili SF-36. A cross-sectional study was conducted as part of a household survey of a representative sample of the adult population of Dar es Salaam, Tanzania. The IQOLA method of forward and backward translation was used to translate the SF-36 into Kiswahili. The translated questionnaire was administered by trained interviewers to 3,802 adults (50% women, mean (SD) age 31 (13) years, 50% married and 60% with primary education). Data quality and psychometric assumptions underlying the scoring of the eight SF-36 scales were evaluated for the entire sample and separately for the least educated subgroup (n = 402), using multitrait scaling analysis. Forward and backward translation procedures resulted in a Kiswahili SF-36 that was considered conceptually equivalent to the US English SF-36. Data quality was excellent: only 1.2% of respondents were excluded because they answered less than half of the items for one or more scales; ninety percent of respondents answered mutually exclusive items consistently. Median item-scale correlations across the eight scales ranged from 0.47 to 0.81 for the entire sample. Median scaling success rates were 100% (range 87.5-100.0). The median internal consistency reliability of the eight scales for the entire sample was 0.81 (range 0.70-0.92). Floor effects were low and ceiling effects were high on five of the eight scales. Results for n = 402 people without formal education did not differ substantially from those of the entire sample. The results of data quality and psychometric tests support the scoring of the eight scales using standard scoring algorithms. The Kiswahili translation of the SF-36 may be useful in estimating the health of people in Dar es Salaam. Evidence for the validity of the SF-36 for use in Tanzania needs to be accumulated.

Activities of Daily Living↗
PubMed2002

[Predictive validity of the original and expanded Norton Scale in geriatric nursing].

Prevention of pressure sores is a central task of nursing. For ethical and economic reasons correct assessment of the risk of pressure sores is a prerequisite of adequate prevention of pressure sores. In Germany the Norton scale is one of the most widespread tools for assessing the risk of pressure sores. For practical purposes the original translated version of the Norton scale is in use, as well as an extended modified version. Validity and reliability of these two versions are in the early stages of examination in Germany. The present descriptive longitudinal study aims at determining the predictive value of both versions of the Norton scale in nursing homes. In a convenience sample of 146 individuals from five nursing homes residents from the age of 60 were assessed by professional nursing staff with the aid of both versions of the Norton scale at weekly intervals. Simultaneously the skin status was recorded on both sampling days. The results exhibit high values of sensitivity (91%-95%) and low specificity (6.2%-20.6%) in both scales. Both scales tend to overrate the risk of pressure sores. The values indicate that the original Norton scale assesses the residents free of pressure sores better than its extended version. Because of the convenience-sample the results are not representative and apply only to the investigated setting and population. The predictive validity of the original and modified version of the Norton scale is insufficiently verified, so there is great need of further investigation of the validity of the two versions. Application of assessment scales in nursing should be supplemented by professional expertise of the nursing staff to counterbalance assessment errors of the tools.

Aged↗
PubMed2005

Insufficient evidence to understand effect of routine scaling and polishing.

DATA SOURCES: Relevant studies were sourced using the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials, Medline and Embase. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted where possible to identify trials and obtain additional information. STUDY SELECTION: Trials were selected if they were randomised, included anyone with an erupted permanent dentition, and where subjects were judged to have received a routine scale and polish as defined in this review. Outcomes assessed included tooth loss, plaque, calculus, gingivitis, bleeding and periodontal indices, changes in probing depth, attachment change, patient-centred outcomes and economic outcomes. DATA EXTRACTION AND SYNTHESIS: Trial details were independently extracted, in duplicate, by two reviewers. Authors were contacted where possible and where deemed necessary for further details regarding study design and for data clarification. A quality assessment of all included trials was carried out. The Cochrane Collaboration's statistical guidelines were followed and both the standardised mean differences and weighted mean differences were calculated, as appropriate, using random-effects models. RESULTS: Eight studies were included in this review and all studies were assessed as having a high risk of bias. Two split-mouth studies provided data for the comparison between scale and polish versus no scale and polish. One study, which involved people attending a recall programme following periodontal treatment, found no statistically significant differences for plaque, gingivitis and attachment loss between experimental and control units at each timepoint during the 1-year trial. The other study, of adolescents in a developing country who had high existing levels of and calculus who had not received any dental treatment for at least 5 years, reported statistically significant improvements in calculus and gingivitis (bleeding) scores between treatment and control units at 6, 12 and 22 months following a single scale and polish provided at baseline to treatment units. For comparisons between routine scale and polish procedures provided at different time intervals, there were some statistically significant differences in favour of scaling and polishing carried out at more frequent intervals, that is, at 2 weeks versus 6 months; 2 weeks versus 12 months (for the outcomes plaque, gingivitis, pocket depth and attachment change); and at 3 months versus 12 months (for the outcomes plaque, calculus and gingivitis). There were no studies comparing the effects of scaling and polishing provided by dentists or professionals complementary to dentistry. CONCLUSIONS: The research evidence is not of sufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals. High-quality clinical trials are required to address the basic questions posed in this review. Scaling and/or polishing of the crown and root surfaces of the teeth to remove local irritational factors (plaque, calculus, debris and staining), that does not involve periodontal surgery or any form of adjunctive periodontal therapy such as the use of chemotherapeutic agents or root planing.

Comment↗
PubMed1999

The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus.

This article summarizes the development and validation of a scale to measure the level of self-efficacy of patients with type 2 diabetes mellitus. Self-efficacy is described as people's belief in their capability to organize and execute the course of action required to deal with prospective situations. This self-efficacy scale was developed based on the self-care activities these patients have to carry out in order to manage their diabetes. The following psychometric properties of this scale were established: content validity, construct validity, internal consistency and stability. The original scale contained 42 items. A panel of five experts in diabetes and four self-efficacy experts evaluated the original scale two times for relevance and clarity. This content validity procedure resulted in a final scale which consisted of 20 items. Subsequently, patients with type 2 diabetes were asked to complete this 20-item scale and further tests were done with the 94 usable responses. Factor analysis identified four factors, all of which were related to clusters of self-care activities used to manage diabetes which comprised this scale. The internal consistency of the total scale was alpha=0.81 and the test-retest reliability with a 5-week time interval was r=0.79 (P < 0.001).

Adult↗