Abstract: In the study of work-related stress among nurses, the Nursing Stress Scale (NSS) is the best known and most widely used scale. This article presents an overview of the NSS and its use, and describes the development of an expanded instrument (ENSS) to measure sources and frequency of stress perceived by nurses. Findings are based on a random sample of 2,280 nurses in Ontario working in a wide range of work settings. Pretests for the study indicated that an expanded version of the NSS was necessary in order to adequately measure sources of stress among nurses. The sources of stress comprised nine subscales--death and dying, conflict with physicians, inadequate preparation, problems with peers, problems with supervisors, workload, uncertainty concerning treatment, patients and their families, and discrimination. Confirmatory factor analyses, run on two randomly selected halves of the sample, came close to meeting standard criteria levels. The alpha coefficients of eight of the subscales were .70 or higher, and concurrent and construct validity assessments provided strong support for the expanded NSS.

Abstract: Continuity of care is a critical component of quality patient care, yet the paucity of reliable and valid measures of continuity of care make it difficult to ascertain the extent to which continuity has been achieved. The purpose of this article is to describe the development of an instrument to measure continuity of care that incorporates the perspectives of elders hospitalized for a chronic illness and their family caregivers. The instrument was used, and its reliability and validity examined, in a series of studies related to elders' posthospital transition. Elders in the studies ranged in age from 55 to 94 years. The findings supported content and construct validity, internal consistency reliability, and ability to detect changes in the same subjects at different points in time for the care management and services subscales. With further refinement, the continuity of provider and conflicting information subscales might also facilitate assessment of care continuity.

Abstract: Abuse and victimization among the elderly have received increased attention in the last few years from practitioners, researchers, and policymakers but remain growing problems, especially for elders who live in public housing. This study assessed the psychometric properties of an existing instrument, the Hwalek-Sengstock Elder Abuse Screening Test (HSEAST), which has been tested in only two studies. The instrument was administered to 100 African American, Hispanic, and White elders living in public housing. Study results were compared to findings from a previous study of elderly groups. A principal components factor analysis of the 15-item instrument supported the 3-factor structure for a total of 10 items (factor loadings = 0.4 or >), explaining 38% of the variance. A discriminant function analysis showed that 6 items were as effective as the 9-item model in classifying cases (71.4%) as abused.

Abstract: Depression is a common health problem in the adolescent population. The Reynolds Adolescent Depression Scale (RADS) is used to measure depression in clinical and community adolescent samples. Although there is available evidence for the reliability and validity of the RADS, there is insufficient documentation of its factor structure. This study examined the factor structure of the RADS in adolescent boys and girls (m-144). Internal consistency reliability ranged from .91 to .94 based on grade level, and was .91 for boys and .93 for girls. Factor analysis resulted in a 5-factor solution. Interpretation of factors were as follows: (a) Factor I--generalized demoralization; (b) Factor II--despondency and worry; (c) Factor III--externalized somatocism; (d) Factor IV--anhedonia; and, (e) Factor V--self-worth.

Abstract: This study replicated the factor model for the Reduced Laffrey Health Conception Scale (RLHCS), which was originally developed by Laffrey (1986) and reduced by Lusk, Kerr, and Baer (1995). Two independent samples of construction workers (n = 697 and n = 510) were used. The samples were predominately Caucasian males (over 97%), with mean ages of 35 and 38 years, respectively. Principal components factor analysis with direct oblimin rotation and structural equation modeling were used to replicate factors and to test the equality of the three observed covariance matrices (factory workers and two groups of construction workers), respectively. Results replicated the two-factor structure (clinical health and overall wellness) found in the earlier study with factory workers (Lusk et al., 1995) and demonstrated factor invariance across different samples.

Abstract: The purpose of this study was to develop and validate a measure of female sexuality, the Female Sexuality Questionnaire (FSQ). A survey design was employed for the study. The sample included 262 adult women ages 18 to 81 (M = 32). Five hundred questionnaires were distributed to a diverse female population representing multiple geographic areas in the U.S. and Canada. Participants were healthy (as per self-report), sexually active and engaged in an intimate relationship. The majority of the sample was premenopausal. Item stems for the FSQ were developed based on the literature and the domain-referenced approach for item generation. A pool of 70 items generated to represent 6 theoretical domains of female sexuality: Reproduction, Beliefs, Intimacy, Body Image, Physical Responsiveness, and Satisfaction were subjected to systematic review by a panel of experts. A 5-point self-report response scale was appended to the 54 items surviving judges' reviews (criterion validity index of 91.3 for the pool of retained items). Data screening and item analysis was performed and yielded 13 items which were removed prior to principal factor analysis (PFA) resulting in a sample of 218 subjects and 41 items. The PFA with quartrimax rotation resulted in a 5-factor solution. Four of the five were consistent with the hypothesized domains of Satisfaction, Physical Responsiveness, Beliefs, and Body Image. The fifth factor suggested an association with Intimacy, and was renamed Relationships. The hypothesized domain of Reproduction was not supported. Twelve items failed to load on any of the factors. Recommendations for alternations of the final version of the FSQ are based upon the empirical results of the item analysis and PFA.

Abstract: This study presents the development and testing of the Overeating Tension Scale. Overeating tension was defined operationally as the total discrepancy score resulting from differences between subjects' ratings of actual and desired feelings before overeating. The 32-item Overeating Tension Scale, derived from Apter's Reversal Theory, measures reported overall tension and motivation-specific tension. The scale initially included 48 items, six items for each of eight motivational states. After two instrument development studies (N = 373, N = 208), items were refined and reduced to a total of 32, or four for each of eight motivational states. The final version of the instrument was tested in two additional studies (N = 330, N = 130) that provided evidence to support the internal consistency reliability of the Overeating Tension Scale. There was support for construct validity using contrasted groups (overweight and normal weight subjects), convergent validity, and factor analysis.

Abstract: Caregiver reciprocity is the collective affective and behavioral expression of exchanges given and received between a caregiver and care receiver, and among family members. This psychometric investigation was designed to further examine the reliability and validity of the revised Caregiver Reciprocity Scale II (CRS II). Items were rewritten to reflect valued exchanges and balance among the entire family network, including spouses. An alpha of .83 for Warmth and Regard; .73 for Intrinsic Rewards of Giving; .83 for Love and Affection; and .75 for Balance Within Family Caregiving indicated acceptable internal consistency. The study, conducted with 176 spouse or adult children caregivers, provides additional support for the conceptual model of the four-factor solution. Construct validity was supported by the standardized factor loadings and goodness-of-fit indices obtained from confirmatory factor analysis. The results of the analysis of the measurement model, taken as a whole, demonstrate that the CRS II has adequate psychometric properties. Model parsimony was supported by an AGFI of .87, combined with an adjusted chi-square between 1.0 to 3.0. All but two item loadings were greater than .50. This, combined with the fact that all standardized loadings were twice the standardized errors and t-values were greater than 2.0, contributes to concluding that convergent validity was strong. Discriminant validity, evaluated by variance extracted estimates, and confidence interval (+/- two standard errors) around the correlation estimate between factors, was adequate. This study provided evidence to support the reliability and validity of the CRS II.

Abstract: Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.

Abstract: Patient satisfaction with health services is used as a measure of the quality of patient care received. The emphasis on accountability and patient as consumer has contributed to the growing interest in studying patient satisfaction. Patient satisfaction with prenatal care services has not been extensively studied including instrumentation to develop a satisfaction scale. The purpose of this study was to develop a reliable and valid scale to measure satisfaction with prenatal care services in St. Petersburg, Russia, using the 6 satisfaction dimensions in Aday and Andersen's Theoretical Framework (1974). It was conducted under the auspices of the World Health Organization, Healthy Cities Project. Although the study was conducted internationally, it provides a basis for further testing of reliability and validity in the United States. A convenience sample of 397 women with uncomplicated pregnancies and normal deliveries was studied (86% response rate). Content, construct, and predictive validity, and reliability testing using Cronbach's alpha was conducted. The scale was found to be an adequate and theoretically sound measure of satisfaction with prenatal care services in Russia. However, rather than the 6 hypothesized satisfaction dimensions, Russian women identified 2 satisfaction subscales or measures for quality of prenatal care received. One was, as hypothesized, convenience, and the other was the doctor's behavior.

Abstract: The aim of the present study was to translate and validate the Incontinence Stress Questionnaire--Staff Reaction (ISQ-SR) for cross-cultural adaptation to Norway. The ISQ-SR is a 30-item questionnaire developed in the U.S.A. by Dr. Lucy C. Yu. The questionnaire examines the experience of nursing home staff when working with patients with urinary incontinence. This article describes both the translation and testing procedure. Statistical analyses were carried out in the following steps of the testing procedure: (a) bivariate examination, (b) principal components factor analysis, (c) determination of internal consistency, (d) frequency analysis, and (e) estimation of test-retest reliability. Finally, the translated and tested questionnaire was compared with the original version. The Norwegian version consists of three factors with a total of 24 items, and is shown to be a valid and reliable version of the ISQ-SR. We conclude that we have achieved equivalence with the original version.