Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy.

BACKGROUND: Allergic rhinitis (AR) is a worldwide health problem with rising prevalence. To enhance the estimation of AR prevalence in epidemiological studies, the Score for AR (SFAR), a screening tool, has been developed and widely used. An 8-item SFAR is a handy, self-administered instrument assessing the information on nasal and eye symptoms, seasonal increase in symptoms, skin test results, and previous AR diagnoses. This study aimed to adapt the SFAR to the Chinese population (CSFAR) and validate it by testing its psychometric properties and diagnostic accuracy. METHODS: This methodological study involved translation and validation phases. Different batches of participants were recruited for the above purposes. RESULTS: In phase 1, the CSFAR obtained satisfactory item (80-100%) and scale level (97.8%) semantic equivalence, content validity index (96.7%), comprehensibility (100%), cross-language testing (κ = 0.44-0.83 for item-to-item agreement; intraclass correlation coefficient [ICC] = 0.95, p < 0.05-0.001). In phase 2, CSFAR showed satisfactory internal consistency (α = 0.83), 1-month (ICC = 0.88) and 1-year stability (ICC = 0.85), and construct validity (significant correlation between CSFAR and impairments induced by AR: r = 0.47, p < 0.001). Based on the receiver-operating characteristic curve, comparing the CSFAR with diagnosis made by specialists, an optimal cutoff value was 6 (sensitivity 81.8% and specificity 80.3%). CONCLUSION: SFAR was translated into a Chinese version, the CSFAR. Satisfactory results were obtained for its equivalence, appropriateness, comprehensibility, and relevance, as well as its reliability and validity. A cutoff value of 6 was recommended to increase the diagnostic accuracy in environments with less pollen. This study provides evidence that the SFAR we adapted for the Chinese population is a valuable tool in AR screening.

Student learning in clinical nursing education: perceptions of the relationship between assessment and learning.

There is a wealth of literature demonstrating that clinical nursing education is an important part of the baccalaureate programme in preparing students for entry into the nursing profession. While much attention has been given to the factors that can affect learning outcomes in the clinical environment, student and teacher perceptions of the relationship between assessment and learning has remained an under-researched area. The purpose of this study was to explore the perceptions about what students learned and how they learned during their clinical practicum, and to examine the role played by assessment in influencing student learning. Data were collected through a series of focus group interviews with groups of nursing students, graduates, and teachers. It was revealed that students' learning during the clinical practicum was, to a large extent, affected by their perceptions of the assessment tasks. As a result, they adopted a surface approach to learning and focused on preparing for the assessment tasks to the detriment of their learning. Assessment, in this study, exerted what has been described as a negative "backwash" effect on learning. Since assessment may also foster student learning in a positive way, suggestions are offered as to what can be done to bring about a positive "backwash" effect.