Psychometric properties of a brief self-reported health-related quality of life measure (HRQoL-IDD) for persons with intellectual and developmental disabilities.

BACKGROUND: To encourage self-determination and address health disparities among persons with intellectual and developmental disabilities, clinicians and researchers rely on self-reported measures like health-related quality of life (HRQoL). This study evaluated the psychometric properties of a theory-driven self-reported HRQoL measure for adults requiring mild to moderate support related to intellectual and developmental disabilities. METHOD: 224 volunteers completed 42 quality of life items developed with extensive input from persons with intellectual and developmental disabilities, family members/caregivers, and providers. The 5-point Likert scale format with visual images of fluid-filled cups represented the range of responses. RESULTS: Exploratory and Unrestricted Factor Analyses yielded 16 HRQoL items with 4 subscales: Functional Well-Being, Emotional Well-Being, Social Well-Being, and Healthy Decision-making. The HRQoL-IDD explained 62.8% of variance, had satisfactory internal consistency (0.73-0.83), stability of reponses, and reading level (2nd grade, ages 7-8). CONCLUSIONS: The HRQoL-IDD is a promising measure of self-reported HRQoL for use in community-based settings for persons requiring mild to moderate support related to intellectual and developmental disabilities.

Developing a Health-Related Quality-of-Life Measure for People With Intellectual Disability.

Using principles of community-based participatory research we developed a new theory-based measure of health-related quality of life (HRQOL) for individuals with intellectual disability (ID). We recruited adults with ID (n = 129) to take part in interviews and review successive versions of HRQOL items. Critical input about content and understandability shaped the items, as did input from four focus groups of parents/caregivers (n = 16) and representative stakeholders from community-based agencies (n = 7). The resulting HRQOL measure, called the HRQOL-IDD, contains 42 items. The response format depicts a gradient of fluid-filled cups ("none" to "full") to represent frequency of experience of each item on a 5-point scale.

Impact of computerized provider order entry (CPOE) on length of stay and mortality.

Objective: To examine changes in patient outcome variables, length of stay (LOS), and mortality after implementation of computerized provider order entry (CPOE). Materials and Methods: A 5-year retrospective pre-post study evaluated 66 186 patients and 104 153 admissions (49 683 pre-CPOE, 54 470 post-CPOE) at an academic medical center. Generalized linear mixed statistical tests controlled for 17 potential confounders with 2 models per outcome. Results: After controlling for covariates, CPOE remained a significant statistical predictor of decreased LOS and mortality. LOS decreased by 0.90 days, P < .0001. Mortality decrease varied by model: 1 death per 1000 admissions (pre = 0.006, post = 0.0005, P < .001) or 3 deaths (pre = 0.008, post = 0.005, P < .01). Mortality and LOS decreased in medical and surgical units but increased in intensive care units. Discussion: This study examined CPOE at multiple levels. Given the inability to randomize CPOE assignment, these results may only be applicable to the local setting. Temporal trends found in this study suggest that hospital-wide implementations may have impacted nursing staff and new residents. Differences in the results were noted at the patient care unit and room levels. These differences may partly explain the mixed results from previous studies. Conclusion: Controlling for confounders, CPOE implementation remained a statistically significant predictor of LOS and mortality at this site. Mortality appears to be a sensitive outcome indicator with regard to hospital-wide implementations and should be further studied.

Oncology Nursing Certification: Relation to Nurses' Knowledge and Attitudes About Pain, Patient-Reported Pain Care Quality, and Pain Outcomes.

PURPOSE/OBJECTIVES: To (a) compare pain knowledge and attitudes between nurses with oncology certified nurse (OCN®) status, non-OCN®-certified nurses, and nurses ineligible for certification and (b) examine the relationships among OCN® status, nurses' knowledge and attitudes about pain, patient-reported quality of nursing pain care, and pain outcomes. 
. DESIGN: Prospective, correlational survey design. Patients were nested within nurses. 
. SETTING: Six inpatient oncology units in three hospitals. SAMPLE: 91 nurses in three states (28 OCN®-certified nurses, 37 noncertified nurses, and 26 not eligible for certification). Certification status was validated for 105 nurses who were matched with a sample of 320 patients. 
. METHODS: Nurses completed a survey, and matched adult patients who were experiencing pain rated their pain care quality and pain experience during the past shift. 
. MAIN RESEARCH VARIABLES: Demographic characteristics, certification status, and responses to the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), Pain Care Quality Survey-Nursing, and modified Brief Pain Inventory (Short Form). 
. FINDINGS: OCN®-certified nurses scored significantly higher on the NKASRP (82% correct) compared to non-OCN® eligible nurses (76%) and non-OCN® ineligible nurses (74%) (p < 0.001). Only 43% overall achieved a benchmark of 80% correct. No statistically significant relationships existed between (a) certification status and pain care quality or pain outcomes or (b) NKASRP and care quality or outcomes (p > 0.05).
. CONCLUSIONS: OCN®-certified nurses' knowledge and attitudes related to pain management were superior to noncertified nurses. Neither knowledge and attitudes nor OCN® status were associated with pain care quality or pain outcomes. 
. IMPLICATIONS FOR NURSING: Knowledge is necessary but insufficient to improve patient outcomes; providing optimal pain care requires action. Sustained efforts to improve cancer pain management are indicated.

Creatine as a Novel Treatment for Depression in Females Using Methamphetamine: A Pilot Study.

OBJECTIVE: Depression among methamphetamine users is more prevalent in females than males, but gender-specific treatment options for this comorbidity have not been described. Reduced brain phosphocreatine levels have been shown to be lower in female methamphetamine users compared to males, and, of relevance, studies have demonstrated an association between treatment-resistant depression and reduced brain phosphocreatine concentrations. The nutritional supplement creatine monohydrate has been reported to reduce symptoms of depression in female adolescents and adults taking antidepressants, as well as to increase brain phosphocreatine in healthy volunteers. Therefore, the purpose of this pilot study was to investigate creatine monohydrate as a treatment for depression in female methamphetamine users. METHODS: Fourteen females with depression and comorbid methamphetamine dependence were enrolled in an 8-week open label trial of 5 g of daily creatine monohydrate and of these 14, 11 females completed the study. Depression was measured using the Hamilton Depression Rating Scale (HAMD) and brain phosphocreatine levels were measured using phosphorus magnetic resonance spectroscopy pre- and post-creatine treatment. Secondary outcome measures included anxiety symptoms, measured with the Beck Anxiety Inventory (BAI), as well as methamphetamine use, monitored by twice weekly urine drug screens and self-reported use. RESULTS: The results of a linear mixed effects repeated measures model showed significantly reduced HAMD and BAI scores as early as week 2 when compared to baseline scores. This improvement was maintained through study completion. Brain phosphocreatine concentrations were higher at the second phosphorus magnetic resonance spectroscopy scan compared to the baseline scan; Mbaseline = 0.223 (SD = 0.013) vs. Mpost-treatment = 0.233 (SD = 0.009), t (9) = 2.905, p <.01, suggesting that creatine increased phosphocreatine levels. Also, a reduction in methamphetamine positive urine drug screens of greater than 50% was observed by week 6. Finally, creatine was well tolerated and adverse events that were related to gastrointestinal symptoms and muscle cramping were determined as possibly related to creatine. CONCLUSIONS: The current study suggests that creatine treatment may be a promising therapeutic approach for females with depression and comorbid methamphetamine dependence. This study is registered on clinicaltrials.gov (NCT01514630).

The Development and Validation of the Interprofessional Attitudes Scale: Assessing the Interprofessional Attitudes of Students in the Health Professions.

PURPOSE: No validated tools assess all four competency domains described in the 2011 report Core Competencies for Interprofessional Collaborative Practice (IPEC Report). The purpose of this study was to develop and validate a tool based on the IPEC Report core competency domains that assesses the interprofessional attitudes of students in the health professions. METHOD: In 2012, an interprofessional team of students and two of the authors developed and administered a survey to students from four colleges and schools at the University of Utah Health Sciences Center (Health, Medicine, Nursing, and Pharmacy). The authors randomly split the responses with complete data into two independent subsets: one for exploratory factor analysis (EFA), the other for confirmatory factor analysis (CFA). They performed these analyses to validate the tool, eliminate redundant questions, and identify subscales. Their analyses focused on aligning tool subscales with the IPEC Report core competencies and demonstrating good construct validity and internal consistency reliability. RESULTS: Of 1,549 students invited, 701 (45.3%) responded. The EFA produced a 27-item scale, with five subscales: teamwork, roles, and responsibilities; patient-centeredness; interprofessional biases; diversity and ethics; and community-centeredness (Cronbach alpha coefficients: 0.62 to 0.92). The CFA indicated that the content of the five subscales was consistent with the EFA model. CONCLUSIONS: The Interprofessional Attitudes Scale (IPAS) is a novel tool that, compared with previous assessment instruments, better reflects current thinking about interprofessional competencies. IPAS should prove useful to health sciences institutions committed to training students to work collaboratively in interprofessional teams.

Measurement considerations for achieving equity in research inclusion for transition-aged youth with disabilities.

Measuring health for youth with intellectual disabilities (ID) is important for tracking progress toward national health goals. Measures of biophysical and fitness indicators are important but difficult to obtain in youth with ID, particularly in community settings. This paper describes obstacles encountered and strategies used to measure outcomes in a community-based study. Proposed best practices include adaptations in procedures to maximize comprehension; preparation of the environment to provide privacy and predictability; and appropriately sized equipment to obtain accurate readings. Reliable and valid measures, specific to youth with ID, would improve promote research inclusion and reduce health disparities for this population.

Older breast cancer survivors: can interaction analyses identify vulnerable subgroups? A report from the American Cancer Society Studies of Cancer Survivors.

PURPOSE/OBJECTIVES: To explore interactions among personal, cancer, aging, and symptom variables relative to physical function (PF) in older adult breast cancer survivors to better identify vulnerable subgroups. DESIGN: Secondary analysis of the American Cancer Society Studies of Cancer Survivors II. SETTING: U.S. population-based mail and telephone survey. SAMPLE: 2,885 breast cancer survivors from 14 different state cancer registries stratified by cancer type and time since diagnosis. A total of 184 female breast cancer survivors, aged 70 years or older, had complete data on variables of interest and were, therefore, included in this analysis. METHODS: Chi-Square Automatic Interaction Detector (CHAID) analysis was used to examine variable interactions. MAIN RESEARCH VARIABLES: PF, symptom bother, comorbidity, social support, length of survivorship, treatment, stage, body mass index, physical activity, emotional health, and personal characteristics. FINDINGS: An interaction effect between symptom bother and comorbidity was found in 39% of older adult breast cancer survivors, and an interaction effect between symptom bother and marital status was found in 40%. The most vulnerable group (8%) had high symptom bother and more than four comorbid conditions. CONCLUSIONS: Symptom bother, comorbidity, and marital status were found to have significant interactions such that high comorbidity and high symptom bother were significantly related to lower PF. Married participants with lower symptom bother had significantly higher PF scores. Comorbidity may be the best predictor of PF for the extreme ends of the symptom bother continuum. Advancing age alone was not a sufficient predictor of PF in this analysis. IMPLICATIONS FOR NURSING: Specific attention to symptom reports, comorbidity, and marital status can guide identification of older adult cancer survivors in need of ongoing survivorship care. The findings support use of a comprehensive assessment and tailored approach to care based on factors other than age. KNOWLEDGE TRANSLATION: CHAID interaction analysis may be useful in exploring complex nursing problems, such as the needs of older adult cancer survivors, and help oncology nurses develop appropriate interventions and referrals.

Confirmatory factor analysis of the pain care quality surveys (PainCQ©).

OBJECTIVE: To examine the reliability and validity and to decrease the battery of items in the Pain Care Quality (PainCQ(©) ) Surveys. DATA SOURCES/STUDY SETTING: Patient-reported data were collected prospectively from 337 hospitalized adult patients with pain on medical/surgical oncology units in four hospitals in three states. STUDY DESIGN: This methodological study used a cross-sectional survey design. Each consenting patient completed two PainCQ(©) Surveys, the Brief Pain Inventory-Short Form, and demographic questions. Clinical data were extracted from the medical record. DATA COLLECTION/EXTRACTION METHODS: All data were double entered into a Microsoft Access database, cleaned, and then extracted into SPSS, AMOS, and Mplus for analysis. PRINCIPAL FINDINGS: Confirmatory factor analysis using Structural Equation Modeling supported the initial factor structure. Modification indices guided decisions that resulted in a superior, parsimonious model for the PainCQ-Interdisciplinary Care Survey (six items, two subscales) and the PainCQ-Nursing Care Survey (14 items, three subscales). Cronbach's alpha coefficients all exceeded .80. CONCLUSIONS: Cumulative evidence supports the reliability and validity of the companion PainCQ(©) Surveys in hospitalized patients with pain in the oncology setting. The tools may be relevant in both clinical research and quality improvement. Future research is recommended in other populations, settings, and with more diverse groups.

The effect of aging and cancer on the symptom experience and physical function of elderly breast cancer survivors.

BACKGROUND: The majority of cancer survivors are aged ≥ 65 years, yet, historically, cancer research has focused infrequently on older patients. The objective of this study was to examine predictors of physical function within a framework that integrates the gerontologic and oncologic needs of older cancer survivors. METHODS: Path analysis tested 759 women who were breast cancer survivors aged ≥ 70 years from the American Cancer Society Study of Cancer Survivors II to examine the cancer, aging, and personal characteristics that had an impact on symptoms and physical functioning. RESULTS: High levels of symptom bother (ß = -.42) and comorbidities (ß = -.21) were strongly associated with lower physical function. Comorbidity and social support (ß = .21) indirectly influenced symptom bother through emotional status (ß = -.35). The model demonstrated good fit with the data (chi-square statistic, 50.6; adjusted chi-square statistic, 2.8; P < .001; goodness-of-fit index, .98; root mean square error of approximation, .049 [confidence interval, .03-.05]). CONCLUSIONS: The current findings supported prior research indicating that the majority of older survivors of breast cancer are doing well, but there is a subset of survivors that requires ongoing attention to symptoms, comorbidities, emotional health, and social support to thrive after cancer treatment.

Validity of the Patient Generated Index as a quality-of-life measure in radiation oncology.

PURPOSE/OBJECTIVES: To evaluate psychometric properties of an instrument designed to measure individualized health-related quality of life (HRQOL). DESIGN: Repeated measures of self-reported quality of life. SETTING: An outpatient radiation therapy department in the western part of the United States. SAMPLE: 86 adults with cancer receiving their first course of radiation therapy. METHODS: The Patient Generated Index (PGI), the National Comprehensive Cancer Network's Distress Thermometer (DT), and the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core-30 (QLQ-C30). MAIN RESEARCH VARIABLES: Convergent validity, responsiveness, sensitivity, and response shift. FINDINGS: PGI scores were inversely correlated with scores on the DT (r = -0.49, -0.55, -0.44; p < 0.001), as well as the role (r = 0.31, 0.4, 0.38; p < 0.01), emotional (r = 0.33, 0.41, 0.33; p < 0.01), social functioning (r = 0.27, 0.49, 0.42; p < 0.05), pain (r = -0.29, -0.39, -0.39; p < 0.01), and fatigue (r = -0.35, -0.25, -0.47; p < 0.05) QLQ-C30 subscales at all measurement times. The PGI was responsive to those reporting high or low DT scores (t = 4.42, 3.32, 2.9; p < 0.05). A small-to-moderate effect size was detected in those who had an increase (effect size = 0.51) or decrease (effect size = 0.38) in HRQOL over time. Participants reconceptualized HRQOL over time. CONCLUSIONS: Data supported the PGI as a valid measure of individualized HRQOL. IMPLICATIONS FOR NURSING: The PGI potentially provides a more patient-centered measure of HRQOL in patients with cancer. Additional testing is needed in larger, more diverse groups.

The validity of neuropathy and neuropathic pain measures in patients with cancer receiving taxanes and platinums.

PURPOSE/OBJECTIVES: To assess the validity of neuropathy and neuropathic pain-measurement approaches. DESIGN: Cross-sectional measurement study. SETTING: Two comprehensive cancer centers in the northeastern United States. SAMPLE: 117 patients with cancer in an outpatient setting. METHODS: Participants were assessed using the five-component Total Neuropathy Score-reduced (TNSr), the TNSr short form (TNSr-SF), individual TNSr items, the Neuropathic Pain Scale for chemotherapy-induced neuropathy (NPS-CIN), and the National Cancer Institute's Common Toxicity Criteria™, version 3.0 (NCI-CTC). MAIN RESEARCH VARIABLES: Neuropathy and pain measure scores, cumulative and per M2 chemotherapy dosage, comorbid risk factors, drug class, and the number of neurotoxic drugs received. FINDINGS: TNSr, TNSr-SF, and tendon reflex scores were greater in patients receiving higher cumulative (z range = -2.2 to -3.6; p range = 0.01 to < 0.001) and per M2 (z range = -1.8 to -2.4; p range = 0.04 to < 0.001) chemotherapy doses. Scores from most neuropathy and pain measures were higher in patients with comorbid illnesses (z range = -1.79 to -3.51; p range = 0.03 to < 0.001). Sensory NCI-CTC scores were higher in patients receiving higher cumulative chemotherapy dosage (z = -2.1; p = 0.02). Only the sensory NCI-CTC correlated with other measures (r range = 0.22-0.63; p range = 0.05 to < 0.001). CONCLUSIONS: Findings support the validity of the TNSr, TNSr-SF, tendon reflex item, NPS-CIN, and NCI-CTC sensory grading scale when measuring taxane and platinum-induced neuropathy. However, additional validity testing is warranted. IMPLICATIONS FOR NURSING: Comprehensive neuropathy and pain measures mainly used by researchers and neurologists were simplified to more clinically useful tools for use by nurses when monitoring chemotherapy-induced peripheral neuropathy.

Modeling relationships in clinical research using path analysis part I: an overview of the process.

Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.

Initial Psychometric Properties of the Pain Care Quality Survey (PainCQ).

UNLABELLED: This study examined the psychometric properties of the Pain Care Quality (PainCQ) survey, a new instrument to measure the quality of nursing and interdisciplinary care related to pain management. Hospitalized medical/surgical oncology patients with pain from 3 states completed the 44-item version of the PainCQ survey following completion of a nursing shift. Interdisciplinary items were evaluated over the entire hospital stay; nursing care was evaluated during the previous shift. The sample included 109 patients ranging in age from 20 to 84 (mean = 53.09). The sample was 58.7% female, 88% non-Hispanic white. Principal Axis Factoring with an oblimin rotation was used as factors were correlated. Two scales resulted. The PainCQ-Interdisciplinary scale included 11 items representing 2 constructs and explaining 47.1% of shared item variance: partnership with the health care team (k = 6 items; α = .85) and comprehensive interdisciplinary pain care (k = 5 items; α = .76). The PainCQ-Nursing scale measured three constructs and explained 60.8 % of shared item variance: being treated right (k = 15 items; α = .95), comprehensive nursing pain care (k = 3 items; α = .77), and efficacy of pain management (k =4 items; α = .87). Results supported the internal consistency reliability and structural validity of the PainCQ survey with 33 items. PERSPECTIVE: This article presents the psychometric properties of a new tool to measure interdisciplinary and nursing care quality related to pain management from the patient's perspective. This tool can be used for research and as a clinical performance measure to monitor and improve quality of care and patient outcomes.

The reliability and validity of a modified total neuropathy score-reduced and neuropathic pain severity items when used to measure chemotherapy-induced peripheral neuropathy in patients receiving taxanes and platinums.

BACKGROUND: Assessment of chemotherapy-induced peripheral neuropathy signs and symptoms has been hampered because of the lack of simple, reliable, and valid measures. OBJECTIVE: The study objective was to examine the internal consistency and interrater reliability as well as the structural validity of a 5-component total neuropathy score-reduced (TNSr) variant and a chemotherapy-induced neuropathy-specific Neuropathic Pain Scale. METHODS: One hundred seventeen outpatients receiving taxanes or platinums were assessed by a consistent nurse practitioner using the 2 instruments. Ten subjects participated in interrater reliability testing. RESULTS: Mean scores and SDs for individual items were low. The strength item was deleted because of low interitem correlations and a floor effect. The reflex item was deleted because of low interitem correlations and its negative influence on Cronbach alpha. Pin sensibility was deleted because of low factor loadings. The TNSr-short form and the chemotherapy-induced neuropathy-specific Neuropathic Pain Scale formed 2 distinct factors, providing evidence of structural validity. Cronbach alpha's for the 2 instruments were .80 and .96, respectively. The TNSr interrater reliability results suggested acceptable rater concordance, but minor revisions could further improve scoring precision. CONCLUSION: Clinimetric evidence supports the use of 2 new instruments when monitoring taxane- and platinum-related neuropathy and pain. Further instrument modifications are recommended, followed by additional testing in diverse populations. IMPLICATIONS FOR PRACTICE: With these new instruments, nurses can more easily incorporate prospective neuropathy assessment into daily clinical practice. The outcome will be improved symptom awareness by oncology clinicians and patients, leading to fewer chemotherapy-induced peripheral neuropathy-related devastating effects on functionality and quality of life.

AMOS versus LISREL: one data set, two analyses.

BACKGROUND: Path analysis is used commonly to evaluate direct and indirect associations among observed variables. Although there are sufficient user guides for commonly referenced structural equation modeling (SEM) software programs, there is little information to help the researcher compare usability and outcomes of these programs. Therefore, deciding which SEM software program to use often presents a challenge for both novice and experienced researchers. OBJECTIVE: To evaluate path analysis results from one data set using two commonly referenced SEM programs, AMOS (Analysis of Moment Structures) Version 6.0 and LISREL (Linear Structural Relations) Version 8.80. APPROACH: Using one data set, each researcher worked solely within one SEM program and was blinded to the solution obtained by the other until analyses were complete. Subsequently, each researcher replicated the other's solution in the opposite program. Finally, a reduced model using modification indices was obtained by each researcher and then compared across SEM programs for similarity. RESULTS: Results showed extremely similar but not totally identical solutions. Modification indices suggested one additional variable and two extra paths in both AMOS and LISREL. DISCUSSION: An examination of the solutions obtained in the two SEM programs suggested small discrepancies in the critical ratios due to rounding, which may have produced subtle alterations in the order of path deletion during model reduction. Despite minor differences, the final solutions could be replicated accurately in each program. Researchers should select an SEM program based on their programming knowledge and the research questions being addressed. Regardless of the program selected, the researcher can have confidence in the comparability of results.

Assessing responsiveness of cancer-related fatigue instruments: distribution-based and individual anchor-based methods.

BACKGROUND: The aims of the study were to examine the responsiveness of Chinese versions of the Cancer Fatigue Scale (C-CFS), the Schwartz Cancer Fatigue Scale-revised (C-SCFS-r), and the Fatigue Symptom Inventory (C-FSI) based on effect sizes and patient perceptions of change. METHOD: Convenience sampling was used to recruit subjects at a chemotherapy treatment center for outpatients in Taiwan. Data were collected twice: on the day cancer patients were receiving chemotherapy treatment (T1) and 2 days post-treatment (T2). RESULTS: Questionnaires were complete at T2 by 148 subjects (60.9%). The differences between T1 and T2 were statistically significant for all three scales. The effect sizes, ranging from a medium to a large change for the C-CFS, C-SCFS-r, and C-FSI were reported based on four groups (self-reported no increase, small increase, moderate increase, and large increase). Generalized estimating equations were used to compare the fatigue scores based on the four groups by controlling for the fatigue level at baseline and the time effect. The results indicate that the fatigue scores after 2 days of treatment in the three "change" groups were statistically significantly larger than in the "no increase" group. In addition, the pretreatment fatigue level in the "large increase" group was significantly higher than in the other three groups. CONCLUSION: Results indicate that the three scales are sensitive to change over 2 days. However, the three scales may not effectively discriminate between a moderate and large change. Therefore, further testing on cancer patients with severe fatigue to examine responsiveness to detect minimal important differences for the three scales is recommended.

Psychometric testing of three Chinese fatigue instruments in Taiwan.

The purpose of this study was to evaluate the psychometric properties (reliabilities and validities) and ease of use of three translated fatigue instruments: Chinese versions of the Cancer Fatigue Scale, the Fatigue Symptom Inventory (FSI), and the Schwartz Cancer Fatigue Scale-revised. Convenience sampling was used to recruit 243 cancer outpatients at a chemotherapy treatment center in Taiwan. The results indicated that the three scales had good internal consistency (Cronbach's alphas for three total scales > 0.80) and were brief (less than 6 minutes to complete), valid (confirmed by convergent, divergent, and discriminant validity), and feasible measures (completion rates > 97%) of fatigue for use with Taiwanese cancer patients. However, 27% of cancer patients reported that the FSI was difficult for them to complete. Differences in factorial validity between each original scale and its Chinese version indicate a need for further testing in Taiwan.

Evaluating a modified exercise self-efficacy scale for college-age women.

This pilot study examined test-retest and internal consistency reliabilities of original and modified formats of the Exercise Self-efficacy Scale in college-age women. 30 completed original and modified versions of the scale. Data from both tests, administered 1 wk. apart, were analyzed using the intraclass correlation coefficient (ICC) to assess test-retest reliability and Cronbach coefficient alpha for internal consistency. Scores for both versions correlated .96. Cronbach coefficients alpha for the original scale were .96 for Time 1 and .98 for Time 2. Cronbach coefficients alpha for the revised scale were .95 for Time 1 and .98 for Time 2. Test-retest reliability and internal consistency remained consistently high for both versions of the scales within this sample. Implications for use of this scale and recommendations for research are given.