Evidence pointing toward invalidity of the SF-8 physical and mental scales: a fusion validity assessment.

Background: The SF-8™ Short Form Health Survey creates physical and mental health scale scores from responses to eight survey questions. These widely used scales demonstrate reasonable reliablity, and some forms of validity but have not been assessed for fusion validity. We assess the fusion validity of the SF-8 physical and mental health scales, and provide comments assisting fusion validity assessment of other scales.

How context links to best practice use in long-term care homes: a mixed methods study.

Background: Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides.

A nursing perspective on the antecedents and consequences of incivility in higher education: A scoping review.

Background: Understanding antecedents and consequences of incivility across higher education is necessary to create and implement strategies that prevent and slow uncivil behaviors.

Purpose: To identify the nature, extent, and range of research related to antecedents and consequences of incivility in higher education.

Objectives: 1) To identify disciplines and programs sampled in higher education incivility research, and 2) to compare antecedents and consequences examined in nursing education research with other disciplines and programs in higher education.

The Influence of Context on Implementation and Improvement: Protocol for a Mixed Methods, Secondary Analyses Study.

Background: Caring for the well-being of older adults is one of the greatest challenges in modern societies. Improving the quality of care and life for older adults and the work lives of their care providers calls for effective knowledge translation of evidence-based best practices.

Objective: This study's purpose is to contribute to knowledge translation by better understanding the roles of organizational context (workplace environment) and facilitation (process or role) in implementation and improvement success.

Fusion Validity: Theory-Based Scale Assessment via Causal Structural Equation Modeling.

Fusion validity assessments employ structural equation models to investigate whether an existing scale functions in accordance with theory. Fusion validity parallels criterion validity by depending on correlations with non-scale variables but differs from criterion validity because it requires at least one theorized effect of the scale, and because both the scale and scaled-items are included in the model. Fusion validity, like construct validity, will be most informative if the scale is embedded in as full a substantive context as theory permits.

Improving measurement-invariance assessments: correcting entrenched testing deficiencies.

Background: Factor analysis historically focused on measurement while path analysis employed observed variables as though they were error-free. When factor- and path-analysis merged as structural equation modeling, factor analytic notions dominated measurement discussions - including assessments of measurement invariance across groups. The factor analytic tradition fostered disregard of model testing and consequently entrenched this deficiency in measurement invariance assessments.

Measuring Depression-Severity in Critically Ill Patients' Families with the Patient Health Questionnaire (PHQ): Tests for Unidimensionality and Longitudinal Measurement Invariance, with Implications for CONSORT.

Context: Families of intensive care unit patients are at risk for depression and are important targets for depression-reducing interventions. Multi-item scores for evaluating such interventions should meet criteria for unidimensionality and longitudinal measurement invariance. The Patient Health Questionnaire (PHQ), widely used for measuring depression severity, provides standard nine-, eight-, and two-item scores.

Reliability and Validity of the Alberta Context Tool (ACT) with Professional Nurses: Findings from a Multi-Study Analysis.

Although organizational context is central to evidence-based practice, underdeveloped measurement hinders its assessment. The Alberta Context Tool, comprised of 59 items that tap 10 modifiable contextual concepts, was developed to address this gap. The purpose of this study to examine the reliability and validity of scores obtained when the Alberta Context Tool is completed by professional nurses across different healthcare settings.

The influence of organizational context on best practice use by care aides in residential long-term care settings.

Objective: This study assessed individual and organizational context (work environment) factors that influence use of best practices by care aides (nursing assistants) in nursing homes. Little scientific attention has been focused on understanding best practice use in nursing homes and almost none on care aides.

Setting And Participants: A total of 1262 care aides in 25 nursing homes in the 3 Canadian prairie provinces.

Shame for disrespecting evidence: the personal consequences of insufficient respect for structural equation model testing.

Background: Inappropriate and unacceptable disregard for structural equation model (SEM) testing can be traced back to: factor-analytic inattention to model testing, misapplication of the Wilkinson task force's [Am Psychol 54:594-604, 1999] critique of tests, exaggeration of test biases, and uncomfortably-numerous model failures.

Discussion: The arguments for disregarding structural equation model testing are reviewed and found to be misguided or flawed. The fundamental test-supporting observations are: a) that the null hypothesis of the χ2 structural equation model test is not nil, but notable because it contains substantive theory claims and consequences; and b) that the amount of covariance ill fit cannot be trusted to report the seriousness of model misspecifications.

Precision of the Conceptual Research Utilization Scale.

Background And Purpose: Conceptual research utilization (CRU) is one indicator of an optimum practice environment that leads to improved patient and organizational outcomes. Yet, its measurement has not been adequately addressed. In this study, we investigated precision of scores obtained with a new CRU scale using item response theory (IRT) methods.

Rural Caregivers for a Family Member With Dementia: Models of Burden and Distress Differ for Women and Men.

Forecasts of increasing prevalence of dementia in rural settings, coupled with reliance on family caregiver support, indicate that a greater understanding of caregiver distress in these contexts is necessary. The purpose of this study was to examine family caregiver burden and severity of distress on the day that a family member was diagnosed with dementia at a memory clinic that serves a rural population. Participants in this retrospective study were 231 primary family caregivers of a rural community-dwelling person with dementia.

The influence of organizational context on the use of research by nurses in Canadian pediatric hospitals.

Background: Organizational context is recognized as an important influence on the successful implementation of research by healthcare professionals. However, there is relatively little empirical evidence to support this widely held view.

Methods: The objective of this study was to identify dimensions of organizational context and individual (nurse) characteristics that influence pediatric nurses' self-reported use of research.

Comparing two approaches for studying symptom clusters: factor analysis and structural equation modeling.

Purpose: We investigated alternative ways of understanding the relationships among co-occurring symptoms in individuals with advanced cancer. While factor analysis has been increasingly used to identify symptom clusters, we argue that structural equation modeling is more appropriate because it permits investigating and testing of a greater variety of potential causal interconnections among symptoms.

Methods: The sample included 82 palliative patients whose symptom scores were obtained from a database of the Capital Health Regional Palliative Care Program in Alberta, Canada, from 1995 to 2000.

A protocol for advanced psychometric assessment of surveys.

Background and Purpose. In this paper, we present a protocol for advanced psychometric assessments of surveys based on the Standards for Educational and Psychological Testing. We use the Alberta Context Tool (ACT) as an exemplar survey to which this protocol can be applied.

Should researchers use single indicators, best indicators, or multiple indicators in structural equation models?

Background: Structural equation modeling developed as a statistical melding of path analysis and factor analysis that obscured a fundamental tension between a factor preference for multiple indicators and path modeling's openness to fewer indicators.

Discussion: Multiple indicators hamper theory by unnecessarily restricting the number of modeled latents. Using the few best indicators - possibly even the single best indicator of each latent - encourages development of theoretically sophisticated models.

Contributions of environment, comorbidity, and stage of dementia to the onset of walking and eating disability in long-term care residents.

Objectives: To estimate the relative effects of environment, comorbidities, stage of dementia and other variables on disability onset.

Design: A 1-year prospective cohort study was conducted in which the walking and eating abilities of long-term care residents were observed fortnightly. Structural equation modeling was used to assess the contributions of individual and environmental factors to the onset of disability.

Advancing the argument for validity of the Alberta Context Tool with healthcare aides in residential long-term care.

Background: Organizational context has the potential to influence the use of new knowledge. However, despite advances in understanding the theoretical base of organizational context, its measurement has not been adequately addressed, limiting our ability to quantify and assess context in healthcare settings and thus, advance development of contextual interventions to improve patient care. We developed the Alberta Context Tool (the ACT) to address this concern.

Temporal changes in the causal foundations of palliative care symptoms.

Purpose: We use longitudinal data to test and extend a structural equation model documenting changes in the causal connections among symptoms experienced in the final weeks of life. Our central thesis is that the relief of suffering and the promotion of quality end of life care require tailoring interventions to reflect the shifting causal foundations of symptoms.

Methods: Symptom information on pain, anxiety, nausea, shortness of breath, drowsiness, loss of appetite, tiredness, depression, and well-being was extracted from a palliative care database.

The relationship between nursing leadership and nurses' job satisfaction in Canadian oncology work environments.

Background: Current Canadian oncology work environments are challenged by the same workforce statistics as other nursing specialties: nurses are among the most overworked, stressed and sick workers, and more than 8% of the nursing workforce is absent each week due to illness.

Aim: To develop and estimate a theoretical model of work environment factors affecting oncology nurses' job satisfaction.

Methods: The sample consisted of 515 registered nurses working in oncology settings across Canada.

The changing causal foundations of cancer-related symptom clustering during the final month of palliative care: a longitudinal study.

Background: Symptoms tend to occur in what have been called symptom clusters. Early symptom cluster research was imprecise regarding the causal foundations of the coordinations between specific symptoms, and was silent on whether the relationships between symptoms remained stable over time. This study develops a causal model of the relationships between symptoms in cancer palliative care patients as they approach death, and investigates the changing associations among the symptoms and between those symptoms and well-being.

An alternative approach to addressing missing indicators in parallel datasets: research utilization as a phantom latent variable.

When doing secondary data analysis, it is not uncommon to find that a key variable was not measured. Often the researcher has no option but to do without the missing indicator, but when nearly parallel datasets exist, the researcher may have other options. In an earlier article leading up to this special issue, this research team was confronted with the problem that research utilization had been measured in only one of two similar datasets, namely, in the 1996 but not the 1998 Alberta Registered Nurse survey.

Understanding hierarchical linear models: applications in nursing research.

Nurses practice within hierarchical organizations and occupational structures. Hence, data emanating from nursing environments are structured, often inherently, hierarchically. From the perspective of ordinary regression, such structuring constitutes a statistical problem because this violates the assumption that we have observed independent and identical cases.

Influence of organizational characteristics and context on research utilization.

Background: Despite three decades of empirical investigation into research utilization and a renewed emphasis on evidence-based medicine and evidence-based practice in the past decade, understanding of factors influencing research uptake in nursing remains limited. There is, however, increased awareness that organizational influences are important.

Objectives: To develop and test a theoretical model of organizational influences that predict research utilization by nurses and to assess the influence of varying degrees of context, based on the Promoting Action on Research Implementation in Health Services (PARIHS) framework, on research utilization and other variables.