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Development and content validity of an instrument for assessing the motivation for weight loss in adolescents with overweight and obesity.
Silva, DFO, Souza, ALS, Pimentel, JB, Souza, TO, Araújo, EPDS, Sena-Evangelista, KCM, Arrais, RF, Lima, SCVC
PloS one. 2020;15(11):e0242680
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Plain language summary
Reduction and control of body weight is an important measure in order to reduce health risks in adolescence and adulthood. The aim of this study was to develop and validate the content of an instrument to assess the motivation for weight loss in adolescents with overweight and obesity. This is a methodological study. The development and content validation of the instrument was conducted in five stages. There were three rounds of evaluation; in the first round the responses of 12 experts were included, in the second round the responses of 10 experts were included and in the final round the responses of four experts were included. Findings show that the content validity evaluation of the items by the panel of experts allowed the selection of the most practical items for adolescents. Additionally, the revisions made in the wording of the items provided a better standardization in the presentation of the items and a clearer language adapted to the age range of the target audience. Authors conclude that further psychometric testing is needed to determine reliability and construct validity of the instrument.
Abstract
OBJECTIVE To develop and validate the content of an instrument for assessing the motivation for weight loss in adolescents with overweight and obesity. METHODS The development and validation of the instrument were conducted in five stages, for which two systematic reviews were conducted. The first one, for the identification of questionnaires assessing the motivation for weight loss, included six studies and contributed to the selection of the domains for the instrument. The second one, conducted to identify the motivations for weight loss in adolescents with overweight and/or obesity, included six studies and contributed to the selection of 17 motivations included in the initial version of the instrument. The motivations most commonly identified were: having better health, improving my appearance, improving my self-esteem and avoiding bullying. The content validity was confirmed by a committee of 12 experts from the areas of nutrition, endocrinology, psychology, and physical education. Based on these evaluations, the content validity index was calculated. Only the items with a content validity index >0.80 for practical relevance were held in the instrument. RESULTS Five of the 17 motivations included in the initial version of the instrument were excluded because they had content validity index <0.80 for practical relevance. Of the 12 items held in the instrument, five were revised by experts in order to standardize wording and make the language more appropriate for adolescents. Experts categorized the items into the health, personal satisfaction, appearance and social domains. CONCLUSIONS This is the first instrument assessing the motivation for weight loss in adolescents with overweight and obesity in Brazil. The content validity evaluation by the panel of experts provided more practical relevance, as well as contributed to a better presentation of the items. Further psychometric testing is needed to determine reliability and construct validity of the instrument.
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Comparison of the construct validity and reproducibility of four different types of patient-reported outcome measures (PROMs) in patients with rheumatoid arthritis.
Renskers, L, van Uden, RJJC, Huis, AMP, Rongen, SAA, Teerenstra, S, van Riel, PLCM
Clinical rheumatology. 2018;37(12):3191-3199
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Plain language summary
Rheumatoid arthritis is an inflammatory autoimmune disease characterised by chronic joint inflammation, which leads to pain, stiffness, function loss, and fatigue. During outpatient visits, patient-reported outcome measures (PROMs) are taking a more central place because they directly apply to the patients’ personal perception and can identify key concerns that need to be addressed. The objective of this study was to measure and compare construct validity of four scale types of PROMs within four different domains. The study is a prospective longitudinal study which recruited adult patients with rheumatoid arthritis. Two-hundred eleven patients were included for the construct validity assessment and one hundred fifty-three patients for the reproducibility assessment. Results showed that within the construct validity assessment, the differences between the four scale types were small and appeared not different. On the other hand, the assessment on reproducibility of the scales was moderate to high. The exception was for the domain of general well-being, as correlations both for construct validity as well as for reproducibility were lower compared to the other domains. Authors conclude that the numerical rating scale is the preferred PROM scale for patients with rheumatoid arthritis.
Abstract
Patient-reported outcome measures (PROMs) are increasingly used in the assessment of patients with rheumatoid arthritis (RA). The aim of this study was to assess the construct validity and reproducibility of four types of PROMs (numerical rating scale (NRS), visual analogue scale (VAS), verbal rating scale (VRS), and Likert scale). In addition, patients' preference for one of these PROMs was measured. Patients with stable RA and no change in pain medication or steroid medication (n = 211) were asked to complete a questionnaire directly following, and 5 days after their outpatient visit. The questionnaire measured the validity of the PROMs in four domains (pain, fatigue, experienced disease activity, and general well-being). To assess construct validity, Pearson correlation coefficients were calculated using the Disease Activity Score-3. To assess reproducibility, intraclass correlation coefficients (ICCs) were calculated. Correlation coefficients between the different PROMs within each domain were compared. There were no differences regarding construct validity between the different PROM scale types. Regarding reproducibility, VAS and NRS scored better in the domains pain and experienced disease activity. Patients chose NRS as preferred measurement method, with the VAS in second place. The four scale types of PROMs appeared to be equally valid to assess pain, fatigue, experienced disease activity, and general well-being. VAS and NRS appeared to be more reliable for measuring pain and experienced disease activity. The patients favoured NRS. In combination with other practical advantages of NRS over VAS, we do advise the NRS as the preferred scale type for PROMs.
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A brief patient-reported outcome instrument for primary care: German translation and validation of the Measure Yourself Medical Outcome Profile (MYMOP).
Hermann, K, Kraus, K, Herrmann, K, Joos, S
Health and quality of life outcomes. 2014;12:112
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Patient-reported outcomes (PROs) are important tools for evaluating the effectiveness of patient-centred care. The Measure Yourself Medical Outcome Profile (MYMOP) is a short 4-item questionnaire which allows patients themselves to nominate up to two symptoms that are concerning them most, and to subjectively assess the change of these symptoms over time following a therapeutic intervention. The aim of this study was to translate the MYMOP from English into German and pilot its use in a primary care setting. 567 participants (476 patients from 34 general practices and 91 patients from 11 CAM practices) were included in this study and completed a MYMOP questionnaire as well as a quality of life questionnaire (called EQ-5D). Out of these, 341 patients (60.1%) completed follow-up questionnaires. 161 of the follow-up patients also rated the change of symptoms on direct questioning on a scale from “much better” to “much worse”. The validity of the German translation of the MYMOP was shown by a high correlation between MYMOP-D and EQ-5D and patient reported change of symptoms. Due to only a small number of patients reporting a worsening of symptoms, validity was only established for patients whose symptoms improved or stayed the same. The authors conclude that the MYMOP-D proved to be a valid tool for assessing patient-centred care and because of its brevity and simplicity, could easily be incorporated into primary health care settings.
Abstract
BACKGROUND Measure Yourself Medical Outcome Profile (MYMOP) is a patient-generated outcome instrument capable of measuring effects from a wide range of health care interventions. This paper reports the translation of this instrument into German (MYMOP-D) and the assessment of validity and sensitivity to change for the MYMOP-D. The instrument was piloted in a German primary care context. METHODS The translation process was conducted according to international guidelines. Recruited patients of both general practitioners and non-medical Complementary and Alternative Medicine (CAM) practitioners ("Heilpraktiker") in the German state of Baden-Wuerttemberg completed a questionnaire comprised of the MYMOP-D and the EQ-5D. Responses were analysed to assess construct validity. For assessing the instrument's sensitivity to change, patients received the MYMOP-D again after four weeks at which point they were also asked for their subjective views on change of symptoms. Correlation between MYMOP-D and EQ-5D and sensitivity to change as gradient in score change and as standardized response mean (SRM) were calculated. RESULTS 476 patients from general practices and 91 patients of CAM practitioners were included. Construct validity of the MYMOP-D was given with a correlation of r = .47 with the EQ-5D. Sensitivity to change for subjective change of symptoms could only be analysed for improvement or no change of symptoms, as only 12 patients reported deterioration of symptoms. Results showed the expected smooth gradient with 2.2, 1.3, and 0.5 points of change for large, little improvement and no change, respectively. SRM for MYMOP-D Profile Score was 0.88. CONCLUSIONS The MYMOP-D shows excellent construct validity. It is able to detect changes when symptoms in patients improve or remain unchanged. Deterioration of symptoms could not be evaluated due to too few data. With its brevity and simplicity, it might be an important tool for enhancing patient-centred care in the German health care context.