Irene Styles

The psychometrics of developing the patient empowerment scale

Abstract Although patient empowerment is widely acknowledged as important by health professionals it remains a somewhat nebulous concept. An initial empowerment measure has been developed through an extensive review of literature combined with a series of in—depth interviews of cancer patients concerning their use of coping strategies. The results were analysed for major themes in relation to sense of control over the illness. A set of twenty—eight statements were formulated from themes into a Likert—type scale for self—completion by 100 cancer patients. The scale could be used in assessing level of empowerment amongst cancer patients thereby establishing through this information, the patients ability to make decisions about coping with their illness.

The structural relationship between attitude and behavior statements from the unfolding perspective.

Empirical correlations between attitudes and behaviors toward a common construct are generally poor. This suggests that attitudes and behaviors do not reflect the same dimension. An alternative hypothesis proposes that these are on the same continuum but reflect different levels of intensity. In this article, a recently developed single peaked response model, consistent with Thurstones original methods for measuring attitudes, was used to analyze the responses of young adolescents to statements concerning attitude and behavior toward the environment. It was found that the behavior statements were at systematically different locations from the attitude statements on the same continuum and that their relationship was easily understood as consistent even though they implied a low correlation between attitude and behavior.

Lost and Found: Reinvention of the Self Following Migration

Migration can impact on a persons identity and this assault can require reworking or establishing aspects of the self. The study involved a cross sectional design, using both quantitative and qualitative methodologies to establish the impact of migration on women from the United Kingdom (UK) and Eire (N = 154) now living in Australia. A major aim was to determine whether the impact of multiple loss (loss of home, major attachment figure, family, community, culture, and social networks) can cause a grief reaction and threatened a persons identity, and, if so, what strategies might be used to buffer this impact and assist reinvention of the self. Bowlbys grieving process was used as a theoretical framework. Women who successfully reached the final stage were able to “reinvent” themselves using social strategies, whereas those less able used solitary strategies. Women, unable to reach the final stage of grieving, suffered psychological distress. The study has implications for future migrants. Migrants who use appropriate strategies to enable settlement and reinvention are also likely to achieve a sense of belonging to the new place.

Linking the Standard and Advanced forms of the Raven'S Progressive Matrices in both the Pencil-And-Paper and Computer-Adaptive-Testing Formats

The concepts of adaptive testing, already used by Binet, and concepts of modern or latent trait theory, already extended from psychophysics by Thurstone, have been brought together by the advent of the computer, particularly the PC. With these developments, it is likely that to test specific abilities, special tests will be constructed for administration only by a computer and not in pencil and paper format. In the meantime, many existing paper-and-pencil tests, which usually are not administered adaptively, are being computerised. Among important tests in the educational and psychological literature, and therefore candidates for computerised administration, are the Ravens Progressive Matrices (RPM). Before some inferences can be made across different modes of presentation, however, it is necessary that the degree of consistency of the responses across the two modes be evaluated in a variety of circumstances and by a variety of processes. This paper describes use of the Rasch latent trait model to help (i) implement computerised administration of the standard and advanced forms of the RPM, (ii) compare the relative item difficulties of the computerised form with those from a pencil-and-paper administration of the same items to a different group of persons, and (iii) to convert scores between the advanced and standard forms of the RPM using the two modes of testing, and to compare these scores with the results of a traditional method of equating reported in the literature.

Psychometric evidence of intellectual growth spurts in early adolescence

A tantalizing idea indicated by both qualitative psychological research and brain research is that intellectual growth includes spurts. Intellectual growth spurts have been difficult to confirm quantitatively because of the lack of a constant unit of measurement for an intellectual variable applicable across different ages and because of problems in conducting longitudinal studies. This article reports quantitative evidence of an intellectual growth spurt during early adolescence by combining (a) modern psychometric modeling that permits transforming discrete responses of persons to test-items into formal measurements, (b) computerized testing with the Raven progressive matrices, and (c) a longitudinal study over 5 years involving 201 students of both genders and from homogeneous socioeconomic and educational backgrounds. No gender differences in the magnitude or the timing of these differences were found although the spurt for girls were clearer than those for boys. The significance of this evidence for educational decisions made during early adolescence is noted, especially in relation to educational assessment and placement.

Perceived status of nurses compared to other health care professionals

The global shortage of nurses indicates that strategies must be in place to attract individuals to the profession. The purpose of this study was to explore the specific motivations/influences that encourage students to undertake a nursing career, their perceived status of nurses, their perceived goals as nurses and their future career pathways. The study involved a cross sectional approach using Ford’s (1986) taxonomy of human goals as a theoretical framework. A questionnaire was administered to 126 nursing students enrolled in the first semester of a nursing degree and 80 students in the final semester. Results revealed the image of nurses continues to be influenced by the media. Findings also show how the perceived status of nurses, within a hospital and community setting differ compared to other health care workers. This result highlights the participants’ lack of knowledge in regard to the role of professionals within the health care industry. Results have implications for nurse education (long and short term) in relation to the role of nurses.

Clinical assessment and computerized testing

It is well known in traditional testing practice in psychology that recognizing and controlling personal factors such as misunderstandings, anxiety, loss of concentration and lack of motivation are vital in obtaining reliable and valid data. To achieve such data, the importance of having persons trained in psychology as test administrators is recognized, and many tests require a trained, registered psychologist for their administration. With the advent of computerized testing, the emphasis in related research has been on its advantages over traditional testing, especially in its efficiency and reliability, with suggestions that the need for a psychologists in testing can be reduced. This paper demonstrates the substantial potential effects of personal factors in computerized testing, and makes the case that, if validity is to be retained, the instead of not needing a trained psychologist to be present, such testing does require one at least as much as traditional testing. The demonstration is based on the observations of a psychologist who was present throughout the testing of 189 children, ranging in age from 9·5 to 15 years as they responded individually to a computerized version of Ravens Progressive Matrices, on two occasions 6 months apart.

The JML estimation of the generalised unfolding model incorporating the latitude of acceptance parameter

Using the hyperbolic cosine model (Andrich & Luo, 1993) as the prototypic model for a single-peaked response process, Luo (in press) introduced a general form for all unidimensional probabilistic unfolding models. In addition to the person and statement location parameters, this general form has an explicit parameter characterising the latitude of acceptance, an important concept in attitude measurement. This general form employs a single operational function, and the difference between various unfolding models is a difference between their operational functions. Because all unfolding models are special cases of the general form, it is possible to develop a general algorithm for the estimation of parameters. With a brief introduction, this paper derives such an algorithm using the joint maximum likelihood principle, which is preferred among various algorithms because it does not require any assumptions about the distribution of person locations. The joint maximum likelihood estimates are not consistent, but a simple correction factor is introduced and shown to work excellently.

Practice effects in medical school entrance testing with the undergraduate medicine and health sciences admission test (UMAT)

BackgroundThe UMAT is widely used for selection into undergraduate medical and dental courses in Australia and New Zealand (NZ). It tests aptitudes thought to be especially relevant to medical studies and consists of 3 sections – logical reasoning and problem solving (UMAT-1), understanding people (UMAT-2) and non-verbal reasoning (UMAT-3). A substantial proportion of all candidates re-sit the UMAT. Re-sitting raises the issue as to what might be the precise magnitude and determinants of any practice effects on the UMAT and their implications for equity in subsequent selection processes.MethodsBetween 2000 and 2012, 158,909 UMAT assessments were completed. From these, 135,833 cases were identified where a candidate had sat once or more during that period with 117,505 cases (86.5%) having sat once, 14,739 having sat twice (10.9%), 2,752 thrice (2%) and 837, 4 or more times (0.6%). Subsequent analyses determined predictors of multiple re-sits as well as the magnitude and socio-demographic determinants of any practice effects.ResultsIncreased likelihood of re-sitting the UMAT twice or more was predicted by being male, of younger age, being from a non-English language speaking background and being from NZ and for Australian candidates, being urban rather than rurally based. For those who sat at least twice, the total UMAT score between a first and second attempt improved by 10.7 ± 0.2 percentiles, UMAT-1 by 8.3 ± 0.2 percentiles, UMAT-2 by 8.3 ± 0.2 percentiles and UMAT-3 by 7.7 ± 0.2 percentiles. An increase in total UMAT percentile score on re-testing was predicted by a lower initial score and being a candidate from NZ rather than from Australia while a decrease was related to increased length of time since initially sitting the test, older age and non-English language background.ConclusionsRe-sitting the UMAT augments performance in each of its components together with the total UMAT percentile score. Whether this increase represents just an improvement in performance or an improvement in understanding of the variables and therefore competence needs to be further defined. If only the former, then practice effects may be introducing inequity in student selection for medical or dental schools in Australia or NZ.

Looking to the future: Nursing as a career goal

Abstract Career paths selected by completing nursing students are of significant interest to educators and professional agencies. This paper presents part of a larger study which investigated students’ influences and motivations for selecting nursing as a career path. The aim of this study was to identify career goals of completing nursing students, what factors influence these goals, preferred areas in which to work and if aged care is considered a career option.. The study employed a cross sectional approach utilizing Ford’s (1986) taxonomy of human goals as a theoretical framework. A questionnaire was administered to 25 students in the final semester of their nursing degree. Preliminary findings showed goals for future practice were limited to midwifery and paediatrics whilst elder care was not perceived as a viable career option. Negative images of nurses continue to prevail and implications for nursing are considered. Despite the small sample, the study provides evidence that to provide suitable care for all members of the community it is essential that all career options within the profession are positively promoted.