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  • 1.
    Hagell, Peter
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Alvariza, Anette
    Ersta Sköndal University College.
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Kristofer, Årestedt
    Linnaeus University.
    Assessment of burden among family caregivers of people with Parkinson’s disease using the Zarit Burden Interview2017In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 53, no 2, p. 272-278Article in journal (Refereed)
    Abstract [en]

    Context: Previous studies have supported the psychometric properties of the 22-item Zarit Burden Interview (ZBI-22) scale among family caregivers of people with various disorders, including Parkinson´s disease (PD). However, its short-forms have not been psychometrically tested among PD family caregivers, and available psychometric analyses have not accounted for the ordinal nature of item-level data.

    Objectives: To assess the psychometric properties of the ZBI-22 and its short forms among family caregivers of people with PD, while taking account for the ordinal nature of data.

    Methods: Cross-sectional postal survey ZBI-22 data from 66 family caregiver members (59% women; mean age, 69.6 years) of a local Swedish PD society branch were analysed according to classical test theory methods based on polychoric/polyserial correlations.

    Results: Missing item responses were ≤5%. Corrected item-total correlations were ≥0.42 and floor-/ceiling effects were <20%, besides for the briefest (4- and 1-item) short-forms (20% and 40% floor effects, respectively). Reliability was good for all scales (ordinal alpha, 0.89-0.95).  External construct validity was in general accordance with a priori expectations. Short-forms demonstrated good criterion-related validity (rs 0.87-0.99) and discriminative ability (AUC, 0.91-0.98) relative to the full ZBI-22.

    Conclusion: This study provides support for the reliability and validity of the ZBI-22 and its various short forms for use among PD family caregivers. In studies where caregiver burden is a central outcome, either ZBI-22 or -12 is suggested for use; other short-forms can be used when caregiver burden is of less central focus or for clinical screening.

  • 2.
    Hagell, Peter
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Department of Health Sciences, Lund University.
    Höglund, Arja
    Reimer, Jan
    Eriksson, Brita
    Knutsson, Ingmari
    Widner, Håkan
    Cella, David
    Measuring fatigue in Parkinson's disease: a psychometric study of two brief generic fatigue questionnaires.2006In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 32, no 5, p. 420-32Article in journal (Refereed)
    Abstract [en]

    This study evaluated and compared the measurement properties of the 13-item Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) and the 9-item Fatigue Severity Scale (FSS) in 118 consecutive Parkinson's disease (PD) patients, using traditional and Rasch measurement methodologies. Both questionnaires exhibited excellent data quality and reliability (coefficient alpha>or=0.9), and acceptable rating scale functionality, and both discriminated between fatigued and nonfatigued patients. Factor and Rasch analyses provided general support for unidimensionality of both FACIT-F and FSS, although they do not appear to measure identical aspects of fatigue. No signs of differential item functioning (DIF) were found for the FACIT-F, whereas potential age DIF was detected for two FSS items. These results support the measurement validity of both questionnaires in PD, although the FACIT-F displayed better measurement precision and modest psychometric advantages over the FSS. Availability of psychometrically sound fatigue measures that are applicable across disorders provides a sound basis for advancing the understanding of this common and distressing complaint.

  • 3.
    Henriksson, Anette
    et al.
    Ersta Sköndal University College.
    Hudson, Peter
    Australien.
    Öhlen, Joakim
    Ersta Sköndal University College.
    Thomas, Kristina
    Australien.
    Holm, Maja
    Ersta Sköndal University College.
    Carlander, Ida
    Karolinska Institutet.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Årestedt, Kristofer
    Linnaeus University.
    Use of the preparedness for caregiving scale in palliative care: a Rasch evaluation study2015In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 50, no 4, p. 533-541Article in journal (Refereed)
    Abstract [en]

    CONTEXT: Studies have shown that family carers who feel more prepared for the caregiver role tend to have more favorable experiences. Valid and reliable methods are needed to identify family carers who may be less prepared for the role of supporting a person who needs palliative care.

    OBJECTIVES: The aim of this study was to evaluate the measurement properties of the original English version as well as a Swedish version of the Preparedness for Caregiving Scale (PCS).

    METHODS: The sample (n=674) was taken from four different intervention studies from Australia and Sweden, all focused on improving family carers' feelings of preparedness. Family carers of patients receiving palliative home care were selected and baseline data were used. The measurement properties of the PCS were evaluated using the Rasch model.

    RESULTS: Both the English and Swedish versions of the PCS exhibit sound measurement properties according to the Rasch model. The items in the PCS captured different levels of preparedness. The response categories were appropriate and corresponded to the level of preparedness. No significant differential item functioning for age and sex were detected. Three items demonstrated differential item functioning by language but did not impact interpretation of scores. Reliability was high (>0.90) according to the Person Separation Index.

    CONCLUSION: The PCS is valid for use among family carers in palliative care. Data provide support for its use across age and gender groups as well as across the two language versions.

  • 4.
    Nilsson, Maria
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Bladh, Stina
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Fatigue in Parkinson’s disease: measurement properties of a generic and a condition-specific rating scale2013In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 46, no 5, p. 737-746Article in journal (Refereed)
    Abstract [en]

    Context: High quality fatigue rating scales are needed to advance understanding of fatigue nd determine the efficacy of interventions. Several fatigue scales are used in Parkinson’s isease, but few have been tested using modern psychometric methodology (Rasch analysis).

    Objectives: To examine the measuring properties of the generic Functional Assessment of hronic Illness Therapy - Fatigue (FACIT-F) scale and the condition-specific 16-item arkinson Fatigue Scale (PFS-16) using Rasch analysis.

    Methods: Postal survey data (n=150; 47% women; mean age, 70) were Rasch analyzed. FS-16 scores were tested according both to the original polytomous and the suggested lternative dichotomized scoring methods.

    Results: The PFS-16 showed overall Rasch model fit whereas the FACIT-F showed signs of isfit, which probably was due to a sleepiness-related item and mixing of ositively/negatively worded items. There was no differential tem functioning by disease uration but by fatigue status (greater likelihood of needing to sleep or rest during the day mong people classified as non-fatigued) in the PFS-16 and FACIT-F. However, this did not mpact total score based estimated person measures. Targeting and reliability (≥0.86) was ood, but the dichotomized PFS-16 showed compromised measurement precision. olytomous and dichotomized PFS-16 and FACIT-F scores identified 6, 3 and 4 statistically istinct sample strata, respectively.

    Conclusion: We found general support for the measurement properties of both scales. owever, polytomous PFS-16 scores exhibited advantages compared to dichotomous PFS-16 nd FACIT-F scores. Dichotomization of item responses compromises measurement recision and ability to separate people, and should be avoided.

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