| 1. |
- Danielsson, Louise, 1979, et al.
(författare)
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Measurement properties of the Swedish clinical outcomes in routine evaluation outcome measures (CORE-OM) : Rasch analysis and short version for depressed and anxious out-patients in a multicultural area
- 2022
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Ingår i: Health and Quality of Life Outcomes. - : NLM (Medline). - 1477-7525. ; 20:1, s. 30-
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The Swedish version of the patient-reported Clinical Outcomes in Routine Evaluation Outcome Measures (CORE-OM) has demonstrated high reliability and acceptable convergent validity in explanatory factor analyses. However, the fundamental scale properties have not yet been validated according to item response theory. The aim of this study was to analyze the measurement properties of the Swedish CORE-OM in a cohort of psychiatric out-patients with depression and anxiety in a multicultural area and to explore combinations of items based on shorter versions of the scale (CORE-10, CORE-6D) to improve measurement properties. METHODS: Data from CORE-OM assessments of 337 patients were analyzed using Rasch analysis. The patients had a mean age of 30 ± 14 years, the majority were women (72%). Requirements for measurement properties were checked: overall model fit, item fit residuals, targeting, internal consistency, differential item functioning and thresholds. Sensitivity to change was also analyzed. RESULTS: The CORE-OM showed high internal consistency (person separation index = 0.947) and adequate targeting, but there was overall model misfit (item trait interaction χ2 = 917.53, p < 0.001), indication of local dependency, and differential item functioning in 9 items. The risk items showed problems with disordered thresholds. The emotional component of the shorter CORE-6D showed the best fit for our sample. Adding 3 items to include depressive and trauma-related content resulted in a unidimensional 8-item set with acceptable reliability, model fit, targeting and sensitivity to change. CONCLUSION: For out-patients with diagnosed depression or anxiety in a multicultural area, the Swedish CORE-OM showed high internal consistency, but also validity problems. Based on the shorter CORE-6D version, a unidimensional 8-item set could be an alternative brief measure of psychological distress for this population, but further validity studies are required. Qualitative studies exploring the CORE-OM items in non-native speakers are also warranted. © 2022. The Author(s).
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| 2. |
- Dannapfel, Petra, et al.
(författare)
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A Self-help Tool to Facilitate Implementation of eHealth Initiatives in Health Care (E-Ready) : Formative Evaluation
- 2022
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Ingår i: JMIR Formative Research. - : JMIR Publications Inc.. - 2561-326X. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: eHealth interventions have the potential to increase the efficiency and effectiveness of health care. However, research has shown that implementing eHealth in routine health care practice is difficult. Organizational readiness to change has been shown to be central to successful implementation. This paper describes the development and formative evaluation of a generic self-help tool, E-Ready, designed to be used by managers, project leaders, or others responsible for implementation in a broad range of health care settings. Objective: The aim of this study is to develop and evaluate a tool that could facilitate eHealth implementation in, for example, health care. Methods: A first version of the tool was generated based on implementation theory (E-Ready 1.0). A formative evaluation was undertaken through expert panels (n=15), cognitive interviews (n=17), and assessment of measurement properties on E-Ready items from 3 different workplaces (n=165) using Rasch analyses. E-Ready 1.0 was also field tested among the target population (n=29). Iterative revisions were conducted during the formative evaluation process, and E-Ready 2.0 was generated. Results: The E-Ready Tool consists of a readiness assessment survey and a hands-on manual. The survey measures perceived readiness for change (willingness and capability) at individual and collective levels: perceived conditions for change at the workplace, perceived individual conditions for change, perceived support and engagement among management, perceived readiness among colleagues, perceived consequences on status quo, and perceived workplace attitudes. The manual contains a brief introduction, instructions on how to use the tool, information on the themes of E-Ready, instructions on how to create an implementation plan, brief advice for success, and tips for further reading on implementation theory. Rasch analyses showed overall acceptable measurement properties in terms of fit validity. The subscale Individual conditions for change (3 items) had the lowest person reliability (0.56), whereas Perceived consequences on status quo (5 items) had the highest person reliability (0.87). Conclusions: E-Ready 2.0 is a new self-help tool to guide implementation targeting health care provider readiness and engagement readiness ahead of eHealth initiatives in, for example, health care settings. E-Ready can be improved further to capture additional aspects of implementation; improvements can also be made by evaluating the tool in a larger sample.
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| 3. |
- Gellerstedt, Martin, 1966-, et al.
(författare)
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Are patients willing to take a more active role? : Questionnaires to measure patients’ willingness to be empowered
- 2022
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 105:3, s. 741-749
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveOne crucial prerequisite for increased patient empowerment is the willingness among patients to take a more active role. The aim of this study was to develop questionnaires for measuring a patient’s willingness to be empowered in general and by using e-health.MethodsThe study was based on a random sample from an online panel. The 800 responders were Swedish citizens and reflected the internet-using population in Sweden regarding age, gender, income, and education. The measurement properties were evaluated according to the Rasch Measurement Theory.ResultsThe analyses showed two questionnaires with adequate fit to the basic measurement model and with high reliability (PSI 0.84 and 0.89, respectively).ConclusionWe conclude that this study generated two questionnaires with an intuitive order of items illustrating an understandable progression of willingness to be empowered in general as well as for e-health.Practice implicationsThe suggested questionnaires are valuable tools supporting the effort to tailor empowerment strategies to meet the patient’s willingness. Questionnaires will also be valuable for evaluating strategies for supporting willingness, studying factors related to willingness and potential inequalities due to e.g. varying digital literacy, and for enabling identification of patient stereotypes using cluster analyses.
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| 4. |
- Melin, Jeanette, et al.
(författare)
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A Novel Metrological Approach to a More Consistent Way of Defining and Analyzing Memory Task Difficulty in Word Learning List Tests with Repeated Trials
- 2022
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Ingår i: Proceedings - 4th RaPID Workshop. - : European Language Resources Association (ELRA). - 9791095546771 ; , s. 17-21
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Konferensbidrag (refereegranskat)abstract
- New candidate diagnostics for cognitive decline and dementia have recently been proposed based on effects such as primacy and recency in word learning memory list tests. The diagnostic value is, however, currently limited by the multiple ways in which raw scores, and in particular these serial position effects (SPE), have been defined and analyzed to date. In this work, we build on previous analyses taking a metrological approach to the 10-item word learning list. We show i) how the variation in task difficulty reduces successively for trials 2 and 3, ii) how SPE change with repeated trials as predicted with our entropy-based theory, and iii) how possibilities to separate cohort members according to cognitive health status are limited. These findings mainly depend on the test design itself: A test with only 10 words, where SPE do not dominate over trials, requires more challenging words to increase the variation in task difficulty, and in turn to challenge the test persons. The work is novel and also contributes to the endeavour to develop for more consistent ways of defining and analyzing memory task difficulty, and in turn opens up for more practical and accurate measurement in clinical practice, research and trials.
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| 5. |
- Melin, Jeanette, et al.
(författare)
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An off-target scale limits the utility of Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) as a measure of well-being in public health surveys
- 2022
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Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 202, s. 43-48
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess the utility and measurement properties for the well-being scale Short Warwick–Edinburgh Mental Well-Being Scale (SWEMWBS) in a Swedish general population survey. Study design: A cross-sectional survey study. Methods: Data were retrieved from the 2018 public health survey in Stockholm County, containing a random sample of 22 856 persons stratified to be representative for the municipalities and districts within the region. The data were analyzed according to Rasch Measurement Theory. Results: Person attribute values are positively skewed (mean 2.32, SD 1.85), with wide gaps in the item threshold attribute values. Overall item fit statistics were acceptable, and person measurement separation reliability was 0.83, indicating three statistically distinct ranges in the estimated well-being values. Conclusion: While the SWEMWBS items indicated acceptable fit to the Rasch measurement model, targeting of items to sample is skewed toward lower levels of well-being, and there is a ceiling effect. Thus, we suggest a careful reconsideration of SWEMWBS as a tool for use in general public health surveys, especially for assessing change over time and group differences, as there are large measurement uncertainties for the majority of cases when the population as a whole is sampled. We encourage revisions applying a coherent and comprehensive ordinal construct theory for well-being to fill the gaps in the upper end of the SWEMWBS scales' item thresholds. The addition of more challenging items would improve targeting for population-based surveys, increase reliability, and provide more actionable information that could be useful in improving individuals' well-being. © 2021 The Authors
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| 6. |
- Melin, Jeanette, et al.
(författare)
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The Role of Entropy in Construct Specification Equations (CSE) to Improve the Validity of Memory Tests : Extension to Word Lists
- 2022
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Ingår i: Entropy. - : MDPI. - 1099-4300. ; 24:7
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Tidskriftsartikel (refereegranskat)abstract
- Metrological methods for word learning list tests can be developed with an information theoretical approach extending earlier simple syntax studies. A classic Brillouin entropy expression is applied to the analysis of the Rey’s Auditory Verbal Learning Test RAVLT (immediate recall), where more ordered tasks—with less entropy—are easier to perform. The findings from three case studies are described, including 225 assessments of the NeuroMET2 cohort of persons spanning a cognitive spectrum from healthy older adults to patients with dementia. In the first study, ordinality in the raw scores is compensated for, and item and person attributes are separated with the Rasch model. In the second, the RAVLT IR task difficulty, including serial position effects (SPE), particularly Primacy and Recency, is adequately explained (Pearson’s correlation = 0.80) with construct specification equations (CSE). The third study suggests multidimensionality is introduced by SPE, as revealed through goodness-of-fit statistics of the Rasch analyses. Loading factors common to two kinds of principal component analyses (PCA) for CSE formulation and goodness-of-fit logistic regressions are identified. More consistent ways of defining and analysing memory task difficulties, including SPE, can maintain the unique metrological properties of the Rasch model and improve the estimates and understanding of a person’s memory abilities on the path towards better-targeted and more fit-for-purpose diagnostics. © 2022 by the authors.
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| 7. |
- Roth, Jenny, et al.
(författare)
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Dry eye symptoms using the Ocular Surface Disease Index inSweden: a short report from a pilot study
- 2022
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Ingår i: Scandinavian Journal of Optometry and Visual Science. - : Norges optikerforbund. - 1891-0882 .- 1891-0890. ; 15:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the prevalence of dryeye symptoms in the Swedish population using a web-basedversion of the ocular surface disease index (OSDI).Aweb-basedversionoftheOSDIquestionswasimplementedin an online form using a software developed by Artologik. Thelink to the form was distributed via Linnaeus University socialmedia pages. Basic demographic information such as age, sexand county of residence was also collected.A total of 404 complete responses were received, 303 respon-dents (75%) were females, the median age = 39 (interquartilerange = 28–53) years, median OSDI-score = 19 (interquartilerange = 9–32). Crude prevalence of dry eye symptoms (cate-gories mild to severe) was 65% (95% CI = 62–75). The differencein prevalence between males and females was statistically sig-nificant (chi-square test,p=0.007).The current study found that the prevalence of dry eye symp-toms among a sample of the Swedish population was 65%.These results highlight the need to investigate further the preva-lence and risk factors for dry eye disease in the Swedish population.
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