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1.  The Early Trauma Inventory Self Report-Short Form: Psychometric Properties of the Korean Version 
Psychiatry Investigation  2012;9(3):229-235.
Experiencing traumatic events in childhood is related to various psychiatric problems in adulthood, and a comprehensive tool for measuring childhood trauma is necessary in this field. This study aimed to examine the psychometric properties, and factor structure of the Korean version of the Early Trauma Inventory Self Report-Short Form (ETISR-SF). ETISR-SF measures the childhood trauma, including physical, and emotional sexual abuse, as well as general traumas.
A clinical and nonclinical samples comprising of 97 subjects from a local community, and 207 patients with the ETISR-SF, were assessed. Other tools, including the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were used to assess clinical symptoms. Additional data from 69 college students was used to examine the test-retest reliability.
The original four-factor model was supported by the confirmatory factor analysis scale [χ2 (351, n=304)=3374.025, p<0.001, TLI=0.969, CFI=0.972, RMSEA=0.030]. The ETISR-SF was found to be a reliable instrument (Cronbach's α=0.869). Comparison of the ETISR-SF scores discriminated the clinical group from that of the control group. The measure showed good convergent and divergent validity, in that the scores were correlated higher with the scores on the CTQ-SF (0.691) than with the scores on the BDI or BAI (0.424, 0.397 respectively). The ETISR-SF was found to be temporally stable, showing the moderate to high correlation (0.844).
These findings suggest that the Korean version of the ETISR-SF appears to be a reliable and valid instrument for the measurement of reported childhood trauma.
PMCID: PMC3440471  PMID: 22993521
Early trauma; Trauma inventory; Validation study; Depression
2.  The Korean Version of the Adolescent Dissociative Experience Scale: Psychometric Properties and the Connection to Trauma among Korean Adolescents 
Psychiatry Investigation  2009;6(3):163-172.
The Adolescent Dissociative Experience Scale (A-DES) is a screening measure for dissociative experience in adolescents. The present study aimed to investigate the reliability, validity and psychometric properties of the Korean version of the Adolescent Dissociative Experience Scale.
The Korean version of the A-DES was administered to a normative group of 371 adolescents aged 12 to 18 years and a traumatized group of 33 adolescents aged 12 to 18 years with known trauma.
The internal consistency was excellent (Cronbach's alpha=0.91) and the test-retest correlation of the A-DES was high (r=0.99). Correlation between the A-DES and other measures of dissociation was moderate (r=0.48). There were no significant age differences in mean total A-DES scores for the normative sample, or for boys or girls separately. Nor were there any significant gender differences for any age group. The mean total score of the A-DES was significantly higher in the traumatized group than in the normative group. There was a statistically significant difference between adolescents with self-reported trauma and those without a trauma history in the normative group.
This study demonstrated that the Korean version of the A-DES is a reliable measure with excellent internal consistency and good stability over a 4-week test-retest interval with single factor structure. It can be used to screen for dissociative symptoms in Korean adolescents between the ages 12 and 18.
PMCID: PMC2796064  PMID: 20046391
Adolescent Dissociative Experience Scale; Dissociation; Adolescents; Trauma; Validity
3.  The Behçet's Disease Quality of Life: Reliability and Validity of the Korean Version 
Yonsei Medical Journal  2008;49(5):698-704.
The Behçet's Disease Quality of Life (BD-QoL) is a BD-specific measure developed in the UK. The aim of this study was to adapt the BD-QoL for use in Korea.
Patients and Methods
The translation was based on the guidelines for cross-cultural adaptation. A total of 201 Korean patients with BD participated in this study. To evaluate the psychometric properties, internal consistency and test-retest reliability were used. Factor analysis was performed to examine the construct validity. To provide further evidence for validity, the correlation of BD-QoL with the Clinical Activity Form for Korean Patients with BD (BDCAF-K) and the Center for Epidemiologic Studies-Depression (CES-D) scales was assessed.
The Korean version had high internal consistency (Cronbach's alpha, 0.93) and test-retest reliability (r = 0.835). Factor analysis of the questionnaire revealed one interpretable factor as a general health-related quality of life factor. The Korean version significantly correlated with scores of CES-D (r = 0.749, p= 0.000), self-rating scale of well-being over the past 28 days (r = 0.446, p= 0.000), and BDCAF-K score (r = 0.502, p = 0.000).
Adaptation of the BD-QoL for use in Korea was successful. Together with the BDCAF-K, it may be a valuable tool for assessing the influence of interventions in BD patients and outcome in clinical trials.
PMCID: PMC2615362  PMID: 18972588
Adaptation; Behçet's Disease; quality of life; reliability; validity
4.  Validation of the Korean version of the pediatric quality of life inventory™ 4.0 (PedsQL™) generic core scales in school children and adolescents using the rasch model 
The Pediatric Quality of Life Inventory™ (PedsQL™) is a child self-report and parent proxy-report instrument designed to assess health-related quality of life (HRQOL) in healthy and ill children and adolescents. It has been translated into over 70 international languages and proposed as a valid and reliable pediatric HRQOL measure. This study aimed to assess the psychometric properties of the Korean translation of the PedsQL™ 4.0 Generic Core Scales.
Following the guidelines for linguistic validation, the original US English scales were translated into Korean and cognitive interviews were administered. The field testing responses of 1425 school children and adolescents and 1431 parents to the Korean version of PedsQL™ 4.0 Generic Core Scales were analyzed utilizing confirmatory factor analysis and the Rasch model.
Consistent with studies using the US English instrument and other translation studies, score distributions were skewed toward higher HRQOL in a predominantly healthy population. Confirmatory factor analysis supported a four-factor and a second order-factor model. The analysis using the Rasch model showed that person reliabilities are low, item reliabilities are high, and the majority of items fit the model's expectation. The Rasch rating scale diagnostics showed that PedsQL™ 4.0 Generic Core Scales in general have the optimal number of response categories, but category 4 (almost always a problem) is somewhat problematic for the healthy school sample. The agreements between child self-report and parent proxy-report were moderate.
The results demonstrate the feasibility, validity, item reliability, item fit, and agreement between child self-report and parent proxy-report of the Korean version of PedsQL™ 4.0 Generic Core Scales for school population health research in Korea. However, the utilization of the Korean version of the PedsQL™ 4.0 Generic Core Scales for healthy school populations needs to consider low person reliability, ceiling effects and cultural differences, and further validation studies on Korean clinical samples are required.
PMCID: PMC2459148  PMID: 18518951
5.  Reliability and validity of psychosocial and environmental correlates measures of physical activity and screen-based behaviors among Chinese children in Hong Kong 
Insufficient participation in physical activity and excessive screen time have been observed among Chinese children. The role of social and environmental factors in shaping physical activity and sedentary behaviors among Chinese children is under-investigated. The purpose of the present study was to assess the reliability and validity of a questionnaire to measure child- and parent-reported psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong.
A total of 303 schoolchildren aged 9-14 years and their parents volunteered to participate in this study and 160 of them completed the questionnaire twice within an interval of 10 days. Intraclass correlation coefficients (ICCs), kappa statistics, and percent agreement were performed to evaluate test-retest reliability of the continuous and categorical variables, respectively. Exploratory factor analyses (EFAs) were conducted to assess convergent validity of the emergent scales. Cronbach's alpha and ICCs were performed to assess internal and test-retest reliability of the emergent scales. Criterion validity was assessed by correlating psychosocial and environmental measures with self-reported physical activity and screen-based behaviors, measured by a validated questionnaire.
Reliability statistics for both child- and parent-reported continuous variables showed acceptable consistency for all of the ICC values greater than 0.70. Kappa statistics showed fair to perfect test-retest reliability for the categorical items. Adequate internal consistency and test-retest reliability were observed in most of the emergent scales. Criterion validity assessed by correlating psychosocial and environmental measures with child-reported physical activity found associations with physical activity in the self-efficacy scale (r = 0.25, P < 0.05), the peer support for physical activity scale (r = 0.25, P < 0.05) and home physical activity environmental (r = 0.14, P < 0.05). Children's screen-based behaviors were associated with the family support for physical activity scale (r = -0.22, P < 0.05) and parental role modeling of TV (r = 0.12, P = 0.053).
The findings provide psychometric support for using this questionnaire for examining psychosocial and environmental correlates of physical activity and screen-based behaviors among Chinese children in Hong Kong. Further research is needed to develop more robust measures based on the current questionnaire, especially for peer influence on physical activity and parental rules on screen-based behaviors.
PMCID: PMC3065395  PMID: 21385418
6.  The Functional Assessment of Cancer Therapy-Prostate (FACT-P) Scales in Men with Prostate Cancer: Reliability and Validity of the Korean Version 
Journal of Korean Medical Science  2006;21(2):295-299.
The Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire is a relevant, worldwide tool used for assessing the health-related quality of life in men with prostate cancer. The purpose of this study was to translate the FACT-P into Korean, to assess its reliability and validity, and to test its discriminative ability between the cancer patients and normal controls. The Korean version was developed via the FACT multilingual translation project. The translated questionnaire was self-administered to 70 prostate cancer patients and 70 age-matched controls. In evaluating its psychometric properties for cancer patients, internal consistency and test-retest reliability were used. Validity was estimated by using inter-subscale correlations and discriminant validity between cancer patients and controls. Cronbach's alpha coefficient for the individual subscales were 0.7 or greater (range 0.73 to 0.89), except for emotional well-being (0.61). The test-retest reliability showed high correlations (intraclass coefficients ranged from 0.72 to 0.93). Inter-subscale correlations demonstrated each subscale was unrelated, but moderate correlation was observed between social/family well-being and functional well-being subscales (r=0.56). The FACT-P scale could discriminate reliably between the cancer patients and controls in most subscales. In conclusion, the Korean version of the FACT-P is a reliable and valid questionnaire in patients with prostate cancer.
PMCID: PMC2734007  PMID: 16614517
Prostatic Neoplasms; Questionnaires; Quality of Life; Cross-Cultural Comparison
7.  Validity and reliability of a self-report instrument to assess social support and physical environmental correlates of physical activity in adolescents 
BMC Public Health  2012;12:705.
The purpose of this study was to examine the internal consistency, test-retest reliability, construct validity and predictive validity of a new German self-report instrument to assess the influence of social support and the physical environment on physical activity in adolescents.
Based on theoretical consideration, the short scales on social support and physical environment were developed and cross-validated in two independent study samples of 9 to 17 year-old girls and boys. The longitudinal sample of Study I (n = 196) was recruited from a German comprehensive school, and subjects in this study completed the questionnaire twice with a between-test interval of seven days. Cronbach’s alphas were computed to determine the internal consistency of the factors. Test-retest reliability of the latent factors was assessed using intra-class coefficients. Factorial validity of the scales was assessed using principle components analysis. Construct validity was determined using a cross-validation technique by performing confirmatory factor analysis with the independent nationwide cross-sectional sample of Study II (n = 430). Correlations between factors and three measures of physical activity (objectively measured moderate-to-vigorous physical activity (MVPA), self-reported habitual MVPA and self-reported recent MVPA) were calculated to determine the predictive validity of the instrument.
Construct validity of the social support scale (two factors: parental support and peer support) and the physical environment scale (four factors: convenience, public recreation facilities, safety and private sport providers) was shown. Both scales had moderate test-retest reliability. The factors of the social support scale also had good internal consistency and predictive validity. Internal consistency and predictive validity of the physical environment scale were low to acceptable.
The results of this study indicate moderate to good reliability and construct validity of the social support scale and physical environment scale. Predictive validity was only confirmed for the social support scale but not for the physical environment scale. Hence, it remains unclear if a person’s physical environment has a direct or an indirect effect on physical activity behavior or a moderation function.
PMCID: PMC3489617  PMID: 22928865
Cross-validation; German; Questionnaire; Motorik-Modul (MoMo); Confirmatory factor analysis
8.  Psychometric Properties of Self-Report Concussion Scales and Checklists 
Journal of Athletic Training  2012;47(2):221-223.
Alla S, Sullivan SJ, Hale L, McCrory P. Self-report scales/checklists for the measurement of concussion symptoms: a systematic review. Br J Sports Med. 2009;43 (suppl 1):i3–i12.
Clinical Question:
Which self-report symptom scales or checklists are psychometrically sound for clinical use to assess sport-related concussion?
Data Sources:
Articles available in full text, published from the establishment of each database through December 2008, were identified from PubMed, Medline, CINAHL, Scopus, Web of Science, SPORTDiscus, PsycINFO, and AMED. Search terms included brain concussion, signs or symptoms, and athletic injuries, in combination with the AND Boolean operator, and were limited to studies published in English. The authors also hand searched the reference lists of retrieved articles. Additional searches of books, conference proceedings, theses, and Web sites of commercial scales were done to provide additional information about the psychometric properties and development for those scales when needed in articles meeting the inclusion criteria.
Study Selection:
Articles were included if they identified all the items on the scale and the article was either an original research report describing the use of scales in the evaluation of concussion symptoms or a review article that discussed the use or development of concussion symptom scales. Only articles published in English and available in full text were included.
Data Extraction:
From each study, the following information was extracted by the primary author using a standardized protocol: study design, publication year, participant characteristics, reliability of the scale, and details of the scale or checklist, including name, number of items, time of measurement, format, mode of report, data analysis, scoring, and psychometric properties. A quality assessment of included studies was done using 16 items from the Downs and Black checklist1 and assessed reporting, internal validity, and external validity.
Main Results:
The initial database search identified 421 articles. After 131 duplicate articles were removed, 290 articles remained and were added to 17 articles found during the hand search, for a total of 307 articles; of those, 295 were available in full text. Sixty articles met the inclusion criteria and were used in the systematic review. The quality of the included studies ranged from 9 to 15 points out of a maximum quality score of 17. The included articles were published between 1995 and 2008 and included a collective total of 5864 concussed athletes and 5032 nonconcussed controls, most of whom participated in American football. The majority of the studies were descriptive studies monitoring the resolution of concussive self-report symptoms compared with either a preseason baseline or healthy control group, with a smaller number of studies (n = 8) investigating the development of a scale.
The authors initially identified 20 scales that were used among the 60 included articles. Further review revealed that 14 scales were variations of the Pittsburgh Steelers postconcussion scale (the Post-Concussion Scale, Post-Concussion Scale: Revised, Post-Concussion Scale: ImPACT, Post-Concussion Symptom Scale: Vienna, Graded Symptom Checklist [GSC], Head Injury Scale, McGill ACE Post-Concussion Symptoms Scale, and CogState Sport Symptom Checklist), narrowing down to 6 core scales, which the authors discussed further. The 6 core scales were the Pittsburgh Steelers Post-Concussion Scale (17 items), Post-Concussion Symptom Assessment Questionnaire (10 items), Concussion Resolution Index postconcussion questionnaire (15 items), Signs and Symptoms Checklist (34 items), Sport Concussion Assessment Tool (SCAT) postconcussion symptom scale (25 items), and Concussion Symptom Inventory (12 items). Each of the 6 core scales includes symptoms associated with sport-related concussion; however, the number of items on each scale varied. A 7-point Likert scale was used on most scales, with a smaller number using a dichotomous (yes/no) classification.
Only 7 of the 20 scales had published psychometric properties, and only 1 scale, the Concussion Symptom Inventory, was empirically driven (Rasch analysis), with development of the scale occurring before its clinical use. Internal consistency (Cronbach α) was reported for the Post-Concussion Scale (.87), Post-Concussion Scale: ImPACT 22-item (.88–.94), Head Injury Scale 9-item (.78), and Head Injury Scale 16-item (.84). Test-retest reliability has been reported only for the Post-Concussion Scale (Spearman r = .55) and the Post-Concussion Scale: ImPACT 21-item (Pearson r = .65). With respect to validity, the SCAT postconcussion scale has demonstrated face and content validity, the Post-Concussion Scale: ImPACT 22-item and Head Injury Scale 9-item have reported construct validity, and the Head Injury Scale 9-item and 16-item have published factorial validity.
Sensitivity and specificity have been reported only with the GSC (0.89 and 1.0, respectively) and the Post-Concussion Scale: ImPACT 21-item when combined with the neurocognitive component of ImPACT (0.819 and 0.849, respectively). Meaningful change scores were reported for the Post-Concussion Scale (14.8 points), Post-Concussion Scale: ImPACT 22-item (6.8 points), and Post-Concussion Scale: ImPACT 21-item (standard error of the difference = 7.17; 80% confidence interval = 9.18).
Numerous scales exist for measuring the number and severity of concussion-related symptoms, with most evolving from the neuropsychology literature pertaining to head-injured populations. However, very few of these were created in a systematic manner that follows scale development processes and have published psychometric properties. Clinicians need to understand these limitations when choosing and using a symptom scale for inclusion in a concussion assessment battery. Future authors should assess the underlying constructs and measurement properties of currently available scales and use the ever-increasing prospective data pools of concussed athlete information to develop scales following appropriate, systematic processes.
PMCID: PMC3418135  PMID: 22488289
mild traumatic brain injuries; evaluation; reliability; validity; sensitivity; specificity
9.  Validation of Edmonton Symptom Assessment System in Korean Cancer Patients 
Journal of pain and symptom management  2013;46(6):10.1016/j.jpainsymman.2013.01.012.
The Edmonton Symptom Assessment System (ESAS) is a brief, widely adopted multidimensional questionnaire to evaluate patient-reported symptoms.
To develop a Korean version of the ESAS (K-ESAS) and to perform a psychometric analysis in Korean patients with advanced cancer.
We tested the K-ESAS in two pilot studies with 15 patients each. We assessed internal consistency, test-retest reliability, and concurrent validity in 163 Korean patients, who completed the K-ESAS along with the Korean versions of the M. D. Anderson Symptom Inventory (K-MDASI) and the Hospital Anxiety and Depression Scale (K-HADS) twice. Thirty-eight patients completed the questionnaires again seven days later to assess responsiveness.
K-ESAS scores had good internal consistency, with a Cronbach’s alpha coefficient of 0.88, indicating that no questions had undue influence on the score. Pearson correlation coefficients for K-ESAS symptom scores between baseline and after 2–4 hours ranged from 0.72 (95% confidence interval [CI] 0.64, 0.79) to 0.87 (95% CI 0.82, 0.90), indicating strong test-retest reliability. For concurrent validity, Pearson correlation coefficients between K-ESAS symptom scores and corresponding K-MDASI symptom scores ranged from 0.70 (95% CI 0.62, 0.77) to 0.83 (95% CI 0.77, 0.87), indicating good concurrent validity. For the K-HADS, concurrent validity was good for anxiety (r = 0.73, 95% CI 0.65, 0.79) but moderate for depression (r = 0.4, 95% CI 0.26, 0.52). For responsiveness, changes in K-ESAS scores after seven days were moderately correlated with changes in K-MDASI scores but weakly correlated with changes in K-HADS scores.
The K-ESAS is a valid and reliable tool for measuring multidimensional symptoms in Korean cancer patients.
PMCID: PMC3851583  PMID: 23628516
advanced cancer; Edmonton Symptom Assessment System; ESAS; Korea
10.  A Korean version of the Oral Impacts on Daily Performances (OIDP) scale in elderly populations: Validity, reliability and prevalence 
This study aimed to develop a Korean version of the OIDP index for elderly people and to assess the levels of sociodental impacts in an older Korean population.
The OIDP index for elderly people was cross-culturally adapted from English into Korean and then the derived instrument was tested for reliability and validity. The study population was elderly (65+ year-old) residents of Gangneung City, South Korea. Twenty two of the 222 senior day centres were randomly selected.
687 people were invited and 668 participated in the study (response rate: 97.2%). The standardized Cronbach's alpha coefficient was 0.85. The OIDP related significantly with different subjective measures of oral and general health (p < 0.001). 62.9% of the people had oral impacts relating to one or more performances, with eating food being the most frequently affected performance (47.6%). More than 70% of people with oral impacts had up to 3 performances affected by oral health conditions.
The Korean OIDP index showed satisfactory validity and internal consistency reliability, confirming its appropriateness for use among older Korean people. The prevalence of oral health related impacts was high. Future studies should focus on the test-retest reliability and the sensitivity to change of the Korean OIDP.
PMCID: PMC2291037  PMID: 18302798
11.  Standardization of the Korean Version of the Posttraumatic Embitterment Disorder Self-Rating Scale 
Psychiatry Investigation  2012;9(4):368-372.
Embitterment is a persistent feeling of being let down or insulted, feeling like a "loser", or feeling revengeful but helpless. In South Korea, social injustice experienced during rapid industrial development and protracted unemployment during the Asian economic crisis may lead to strong feelings of embitterment. North Korean defectors and victims of industrial disasters may also experience humiliation and feelings of injustice. Posttraumatic Embitterment Disorder (PTED) is a recent conceptualization of a new psychiatric disorder. This study tested the reliability and validation of the Korean version of the PTED Scale.
Subjects aged 18 years or older were recruited from a psychiatric outpatient clinic. All subjects were diagnosed with a depressive disorder. Subjects completed the Korean version of the PTED Scale, the Patient Health Questionnaire (PHQ-9) and the Patient Health Questionnaire (PHQ-15) at baseline and two weeks later.
Approximately 15.4% of subjects could be categorized as having PTED. The test-retest reliability of the PTED Scale was good (r=0.76) and the internal consistency was very high (Cronbach's alpha=0.962). Positive correlations were found between the PTED Scale, the PHQ-9 and the PHQ-15, indicating substantial convergent validity of the PTED Scale.
The Korean version of the PTED Scale is a reliable and valid measurement of embitterment in Korean adults as an emotional reaction to a negative life event.
PMCID: PMC3521113  PMID: 23251201
Embitterment; PTED; PHQ-9; PHQ-15
12.  Reliability and Validity of the Korean Version of the Empathy Quotient Scale 
Psychiatry Investigation  2010;7(1):24-30.
The Empathy Quotient (EQ) is a self-reported test developed by Baron-Cohen et al. (2004) to measure the cognitive and affective aspects of empathy. The purpose of this study was to develop a Korean version of EQ and to establish its psychometric properties based on a representative Korean sample.
The Korean version of EQ and its correspondence with another popular measure of empathy, the Korean version of the Interpersonal Reactivity Index (IRI), were evaluated in a sample of 478 volunteers (156 men, 322 women; mean age, 27.2 years). A test-retest study was conducted at 1 month on a selected sample of 20 subjects from the original sample. Correlation and confirmatory factor analyses were conducted.
The test-retest reliability was good, and the internal consistency was acceptable (Cronbach's alpha=0.78). Positive correlations were found between the EQ and three subfactors of the IRI, perspective taking, empathic concern, and fantasy, and the total EQ score was negatively correlated with the personal distress subscale. The confirmatory analyses suggested that the three-factor structure offered a good fit to the data.
These findings support the reliability and validity of the Korean version of the EQ.
PMCID: PMC2848769  PMID: 20396429
Empathy Quotient; Reliability; Validity; Autism Spectrum Disorder; Interpersonal Reactivity Index
13.  Psychometric Validation of a Short Acculturation Scale for Korean Immigrants 
Nursing research  2011;60(4):240-246.
Acculturation has been identified as a determinant of health behavior and outcome among ethnic minorities. The high prevalence of lifestyle related chronic diseases and risk factors among Korean immigrants calls for a valid short acculturation scale to use in clinical practice and health research settings.
To validate the psychometric properties of a Short Acculturation Scale originally developed for Hispanics (SASH) after translating the scale to Korean (SAS-K) to determine its suitability for use with Korean immigrants.
A self-administered questionnaire was completed by 143 Korean immigrants with type 2 diabetes aged 30–80 years from a Korean community in Southern California. Confirmatory factor analysis, criterion validity, and internal reliability were utilized to evaluate the psychometric properties of the SAS-K.
Using a second-order confirmatory factor analysis, a three-factor structure [χ2 (51) = 121.49, p < .001, CFI = .950, SRMR = .055, RMSEA = .099] was confirmed. The SAS-K was associated positively with length of residence, age of arrival, and English proficiency. Reliability for the total SAS-K was .93. Cronbach’s alpha coefficients for each subscale of the SAS-K ranged from .80 (social relations) to .95 (media).
The 12-item, easy-to-use SAS-K demonstrated satisfactory reliability and validity and thus is an appropriate instrument for measuring acculturation in Korean immigrants. The short nature and ease of administration of the SAS-K makes it an ideal choice for healthcare providers and researchers to assess acculturation levels quickly and easily, and to further the development and use of more culture-appropriate interventions.
PMCID: PMC3128185  PMID: 21677595
short acculturation scale; psychometric validation; Korean immigrants
14.  Development and psychometric testing of the active aging scale for Thai adults 
Active aging is central to enhancing the quality of life for older adults, but its conceptualization is not often made explicit for Asian elderly people. Little is known about active aging in older Thai adults, and there has been no development of scales to measure the expression of active aging attributes.
The aim of this study was to develop a culturally relevant composite scale of active aging for Thai adults (AAS-Thai) and to evaluate its reliability and validity.
Eight steps of scale development were followed: 1) using focus groups and in-depth interviews, 2) gathering input from existing studies, 3) developing preliminary quantitative measures, 4) reviewing for content validity by an expert panel, 5) conducting cognitive interviews, 6) pilot testing, 7) performing a nationwide survey, and 8) testing psychometric properties. In a nationwide survey, 500 subjects were randomly recruited using a stratified sampling technique. Statistical analyses included exploratory factor analysis, item analysis, and measures of internal consistency, concurrent validity, and test–retest reliability.
Principal component factor analysis with varimax rotation resulted in a final 36-item scale consisting of seven factors of active aging: 1) being self-reliant, 2) being actively engaged with society, 3) developing spiritual wisdom, 4) building up financial security, 5) maintaining a healthy lifestyle, 6) engaging in active learning, and 7) strengthening family ties to ensure care in later life. These factors explained 69% of the total variance. Cronbach’s alpha coefficient for the overall AAS-Thai was 0.95 and varied between 0.81 and 0.91 for the seven subscales. Concurrent validity and test–retest reliability were confirmed.
The AAS-Thai demonstrated acceptable overall validity and reliability for measuring the multidimensional attributes of active aging in a Thai context. This newly developed instrument is ready for use as a screening tool to assess active aging levels among older Thai adults in both community and clinical practice settings.
PMCID: PMC4116362  PMID: 25092971
active aging; scale development; psychometric evaluation; culturally sensitive measure; Thai elderly
15.  Testing a self-determination theory model of children’s physical activity motivation: a cross-sectional study 
Understanding children’s physical activity motivation, its antecedents and associations with behavior is important and can be advanced by using self-determination theory. However, research among youth is largely restricted to adolescents and studies of motivation within certain contexts (e.g., physical education). There are no measures of self-determination theory constructs (physical activity motivation or psychological need satisfaction) for use among children and no previous studies have tested a self-determination theory-based model of children’s physical activity motivation. The purpose of this study was to test the reliability and validity of scores derived from scales adapted to measure self-determination theory constructs among children and test a motivational model predicting accelerometer-derived physical activity.
Cross-sectional data from 462 children aged 7 to 11 years from 20 primary schools in Bristol, UK were analysed. Confirmatory factor analysis was used to examine the construct validity of adapted behavioral regulation and psychological need satisfaction scales. Structural equation modelling was used to test cross-sectional associations between psychological need satisfaction, motivation types and physical activity assessed by accelerometer.
The construct validity and reliability of the motivation and psychological need satisfaction measures were supported. Structural equation modelling provided evidence for a motivational model in which psychological need satisfaction was positively associated with intrinsic and identified motivation types and intrinsic motivation was positively associated with children’s minutes in moderate-to-vigorous physical activity.
The study provides evidence for the psychometric properties of measures of motivation aligned with self-determination theory among children. Children’s motivation that is based on enjoyment and inherent satisfaction of physical activity is associated with their objectively-assessed physical activity and such motivation is positively associated with perceptions of psychological need satisfaction. These psychological factors represent potential malleable targets for interventions to increase children’s physical activity.
PMCID: PMC3852537  PMID: 24067078
Motivation; Physical activity; Children; Self-determination theory; Physical activity
16.  Validation of the Korean version of the Scoliosis Research Society-22 questionnaire 
European Spine Journal  2011;20(10):1751-1756.
We evaluated the reliability and validity of an adapted Korean version of the Scoliosis Research Society-22 (SRS-22) questionnaire.
Materials and methods
Translation/retranslation of the English version of SRS-22 was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the SRS-22 questionnaire and the previously validated Short Form-36 (SF-36) outcome instruments were mailed to 102 patients who had been treated surgically for idiopathic scoliosis. Eighty-two patients responded to the first mailing of questionnaires and 64 of the first-time responders returned their second survey. The average age of the 64 patients (56 females and 8 males) was 18.3 years. Reliability assessment was determined by estimating Cronbach’s α and intraclass correlation coefficient (ICC), respectively. Concurrent validity was evaluated by comparing SRS-22 domains with relevant domains in the SF-36 questionnaire using Pearson’s correlation coefficient.
The study demonstrated satisfactory internal consistency (Cronbach’s α = 0.80–0.89) for function/activity, pain and mental health, and good consistency (Cronbach’s α = 0.50–0.79) for the remaining domains. The ICC of all domains demonstrated excellent test/retest reproducibility. Considering concurrent validity, 3 domains showed excellent correlation, 9 domains good, 25 domains moderate, and 3 domains poor.
The adapted Korean version of the SRS-22 questionnaire was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for treatment outcome assessments in the Korean-speaking patients with idiopathic scoliosis.
PMCID: PMC3175885  PMID: 21670944
Idiopathic scoliosis; Scoliosis Research Society-22; Korean version
17.  Translation and Validation of the Korean Version of the 39-Item Parkinson's Disease Questionnaire 
Background and Purpose
The importance of health-related quality of life (HrQoL) has been increasingly emphasized when assessing and providing treatment to patients with chronic, progressive, degenerative disorders. The 39-item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient-reporting scale to assess HrQoL in Parkinson's disease (PD). This study evaluated the validity and reliability of the translated Korean version of the PDQ-39 (K-PDQ-39).
One hundred and two participants with PD from 10 movement disorder clinics at university-affiliated hospitals in South Korea completed the K-PDQ-39. All of the participants were also tested using the Unified Parkinson's Disease Rating Scale (UPDRS), Korean version of the Mini-Mental State Examination (K-MMSE), Korean version of the Montgomery-Asberg Depression Scale (K-MADS), Epworth Sleepiness Scale (ESS) and non-motor symptoms scale (NMSS). Retests of the K-PDQ-39 were performed over time intervals from 10 to 14 days in order to assess test-retest reliability.
Each K-PDQ-39 domain showed correlations with the summary index scores (rS=0.559-0.793, p<0.001). Six out of eight domains met the acceptable standard of reliability (Cronbach's α coefficient ≥0.70). The Guttman split-half coefficient value of the K-PDQ-39 summary index, which is an indicator of test-retest reliability, was 0.919 (p<0.001). All of the clinical variables examined except for age, comprising disease duration, levodopa equivalent dose, modified Hoehn and Yahr stage (H&Y stage), UPDRS part I, II and III, mood status (K-MADS), cognition (K-MMSE), daytime sleepiness (ESS) and (NMSS) showed strong correlations with the K-PDQ-39 summary index (p<0.01).
The K-PDQ-39 has been validated for use in the Korean-speaking PD population. The questionnaire is a valid and reliable assessment tool for assessing the HrQoL of Korean PD patients.
PMCID: PMC3543906  PMID: 23346157
Parkinson's disease; quality of life; validation
To develop and evaluate the psychometric properties of a new bathing disability scale.
Reliability and validity study.
General community.
Two subsets of community-living older persons, selected from an ongoing longitudinal study, who had some degree of bathing disability or were at increased risk for bathing disability, as determined during a comprehensive assessment at 36 (N=199) and 54 (N=213) months, respectively.
Not applicable.
Main Outcome Measures
The bathing disability scale was administered at 36, 54, and 72 months and changes in scores were assessed between 36 and 54 months and 54 and 72 months, respectively, for the two subsets of participants. Convergent construct validity was evaluated by comparisons with changes in ADL (activities of daily living) disability, mobility disability, and the Short Physical Performance Battery (SPPB). Discriminative construct validity was determined by comparisons according to age and physical frailty. Responsiveness was evaluated by comparisons between participants who had and had not been hospitalized and, subsequently, by plotting correlations according to the timing of these hospitalizations.
The test-retest reliability was high, with an intraclass correlation coefficient=0.76 (95% confidence interval, 0.59–0.94). The internal consistency reliability was excellent with Cronbach’s alpha=0.91–0.97. Changes in scores on the bathing disability scale were positively correlated with changes in scores in ADL and mobility disability and inversely correlated with changes in scores on the SPPB. A greater decline in scores was observed among the oldest old and those who were physically frail, but these differences did not consistently achieve statistical significance. The scale was responsive to the occurrence and/or timing of intervening hospitalizations.
The bathing disability scale is reliable, valid, and responsive and may be suitable for use in clinical trials to evaluate the effectiveness of interventions to enhance independent bathing.
PMCID: PMC2755074  PMID: 19480875
Frail elderly; Disability evaluation; Reliability and validity
19.  Reliability and Validity of the Korean Version of the Internet Addiction Test among College Students 
Journal of Korean Medical Science  2013;28(5):763-768.
We developed a Korean translation of the Internet Addiction Test (KIAT), widely used self-report for internet addiction and tested its reliability and validity in a sample of college students. Two hundred seventy-nine college students at a national university completed the KIAT. Internal consistency and two week test-retest reliability were calculated from the data, and principal component factor analysis was conducted. Participants also completed the Internet Addiction Diagnostic Questionnaire (IADQ), the Korea Internet addiction scale (K-scale), and the Patient Health Questionnaire-9 for the criterion validity. Cronbach's alpha of the whole scale was 0.91, and test-retest reliability was also good (r = 0.73). The IADQ, the K-scale, and depressive symptoms were significantly correlated with the KIAT scores, demonstrating concurrent and convergent validity. The factor analysis extracted four factors (Excessive use, Dependence, Withdrawal, and Avoidance of reality) that accounted for 59% of total variance. The KIAT has outstanding internal consistency and high test-retest reliability. Also, the factor structure and validity data show that the KIAT is comparable to the original version. Thus, the KIAT is a psychometrically sound tool for assessing internet addiction in the Korean-speaking population.
PMCID: PMC3653091  PMID: 23678270
Internet Addiction Test; Reliability, Validity; Internet Addiction; Factor Analysis
20.  Validation of the Korean version of the Roland–Morris Disability Questionnaire 
European Spine Journal  2011;20(12):2115-2119.
We evaluated the reliability and validity of an adapted Korean version of the Roland–Morris Disability Questionnaire (RMDQ). Translation/retranslation of the English version of RMDQ was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the Visual Analog Scale (VAS) measure of pain, RMDQ, and the previously validated Oswestry Disability Index (ODI) were mailed to 100 consecutive patients with chronic lower back pain (LBP) of at least 3 months. Eighty-one patients responded to the first mailing of questionnaires and 63 of the first-time responder returned their second survey. The average age of the 63 patients (45 female, 18 male) was 47.8 years. Reliability assessment was determined by estimating kappa statistics of agreement for each item, the intraclass correlation coefficient (ICC), and Cronbach’s α. Concurrent validity was evaluated by comparing the responses of RMDQ with the results of VAS and responses of ODI by using Pearson’s correlation coefficient. The constructed Bland–Altman plot showed a good reliability. All items had a kappa statistics of agreement greater than 0.6. The RMDQ showed excellent test/re-test reliability as evidenced by the high ICC for 2 test occasions (ICC = 0.932, P < 0.001). Internal consistency was found to be very good at both assessments with Cronbach’s α (0.942 and 0.951 at first and second assessments, respectively). The RMDQ was correlated with the VAS (r = 0.692; P = 0.000 and r = 0.668; P = 0.000 at first and second assessments, respectively), and with the ODI (r = 0.789; P = 0.000 and r = 0.802; P = 0.000, respectively). The adapted Korean version of the RMDQ was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for outcome assessments in the Korean speaking patients with LBP.
PMCID: PMC3229737  PMID: 21479853
Low back pain; Roland–Morris Disability Questionnaire; Korean version
21.  Validation of the Korean Version of the Oxford Knee Score in Patients Undergoing Total Knee Arthroplasty 
Although translated versions of the Oxford Knee Score (OKS) in several languages are available, the absence of a Korean version precludes comparing data from Korea with that from other countries using the OKS.
We therefore evaluated the reliability and validity of the adapted Korean version of the OKS.
We first translated the English version of the OKS into Korean, then back into English, then held expert committee discussions to finalize the Korean version. We then mailed the Korean version of the VAS for pain, OKS, and the previously validated SF-36 to 142 patients who underwent TKAs for knee osteoarthritis. Factor analysis and reliability assessment using the kappa statistic of agreement for each item, the intraclass correlation coefficient, and Cronbach’s alpha were conducted. To determine the subscales of the OKS, we used the factor analysis. We also evaluated concurrent and construct validity by comparing the responses to the OKS with the results of the VAS and SF-36 using Pearson’s correlation coefficient.
All items had a kappa statistic of agreement greater than 0.6. The OKS showed test and retest reliability as follows: OKS, 0.848; Factor 1, 0.867; and Factor 2, 0.819. Internal consistency of Cronbach’s alpha was as follows: OKS, 0.932; Factor 1, 0.907; Factor 2, 0.867. The OKS correlated (r = 0.692) with the VAS. The Korean version of the OKS correlated with the SF-36 total and individual domain (physical functioning, role physical, bodily pain) scores.
The adapted Korean version of the OKS was translated and showed acceptable measurement properties. The data suggest it is suitable for assessing outcomes in Korean-speaking patients having TKAs.
PMCID: PMC3549197  PMID: 22965258
22.  Reliability and Validity of the Korean Version of QOLIE-10 in Epilepsy 
Background and Purpose
It is necessary in clinical practice to screen patients with epilepsy for quality-of-life factors. The purpose of this study was to develop a Korean version of the Quality of Life in Epilepsy (QOLIE)-10 survey and to determine its reliability and validity.
Data were collected from 397 adult epilepsy patients. The ten items of QOLIE-10 were derived from the Korean version of QOLIE-31. We assessed factor analysis, internal consistency, test-retest reliabilities, construct validity, and discriminant validity. Test-retest was performed in 97 patients.
The ten items of QOLIE-10 were grouped into two factors: epilepsy effects/role function (driving, social, work, physical effect, mental effect, and memory) and mental health (overall quality of life, depression, and energy). The internal consistency reliability coefficient (Cronbach's α) was 0.843 for epilepsy effects/role function and 0.606 for the mental-health scale. Test - retest data revealed statistically significant correlations for individual items (range, r=0.66-0.38) and scales (range, r=0.63-0.48), except for one item, driving (r=0.21, p=0.133). QOLIE-10 was significantly correlated with the source scales in the Korean version of QOLIE-31 and with several external measures. The QOLIE-10 scores discriminated between patient groups according to their seizure severity and level of education.
QOLIE-10 was derived from the Korean version of QOLIE-31. The results of this study show that QOLIE-10 can be applied as a screening measure of quality of life in Korean epilepsy patients.
PMCID: PMC2854973  PMID: 20396526
Epilepsy; Quality of life; QOLIE-31; QOLIE-10
23.  Development and Reliability Testing of a Health Action Process Approach Inventory for Physical Activity Participation among Individuals with Schizophrenia 
Individuals with schizophrenia tend to have high levels of cardiovascular disease and lower physical activity (PA) levels than the general population. Research is urgently required in developing evidence-based behavioral interventions for increasing PA in this population. One model that has been increasingly used to understand the mechanisms underlying PA is the health action process approach (HAPA). The purpose of this study was to adapt and pilot-test a HAPA-based inventory that reliably captures salient, modifiable PA determinants for individuals with schizophrenia. Initially, 12 outpatients with schizophrenia reviewed the inventory and provided verbal feedback regarding comprehension, item relevance, and potential new content. A content analysis framework was used to inform modifications to the inventory. The resultant inventory underwent a quantitative assessment of internal consistency and test–retest reliability. Twenty-five outpatients (Mage = 41.5 ± 13.5 years; 64% male) completed the inventory on two separate occasions, 1 week apart. All but two scales showed good internal consistency (Cronbach’s α = 0.62–0.98) and test–retest correlations (rs = 0.21–0.96). Preliminary assessment of criterion validity of the HAPA inventory showed significant, large-sized correlations between behavioral intentions and both affective outcome expectancies and task self-efficacy, and small to moderate correlations between self-reported minutes of moderate-to-vigorous PA and the volitional constructs of the HAPA model. These findings provide preliminary support for the reliability and validity of the first-ever inventory for examining theory-based predictors of moderate-to-vigorous PA intentions and behavior among individuals with schizophrenia. Further validation research with this inventory using an objective measure of PA behavior will provide additional support for its psychometric properties within the schizophrenia population.
PMCID: PMC4051131  PMID: 24959152
schizophrenia; physical activity; determinants; theory-based; reliability testing; measurement
24.  Reliability and Validity of the Korean Version of the Lifespan Sibling Relationship Scale 
Experimental Neurobiology  2013;22(4):330-336.
The sibling relationship and its potential impact on neurodevelopment and mental health are important areas of neuroscientific research. Validation of the tools assessing the quality of the sibling relationship would be the first essential step for conducting neurobiological and psychosocial studies related to the sibling relationship. However, to the best of our knowledge, no sibling relationship assessment tools have been empirically validated in Korean. We aimed to evaluate the psychometric properties of the Korean version of the Lifespan Sibling Relationship Scale (LSRS), which is one of the most commonly used self-report questionnaires to assess the quality of the sibling relationship. A total of 109 adults completed a series of self-report questionnaires including the LSRS, the mental health subscale of the Medical Outcomes Study-Short Form 36 version 2 (SF36v2), the Satisfaction with Life Scale (SLS), and the Marlowe-Crowne Social Desirability Scale (MC-SDS). The internal consistency, subscale intercorrelations, one-week test-retest reliability, convergent validity, divergent validity, and the construct validity were assessed. All six subscale scores and the total score of the LSRS demonstrated good internal consistency (Cronbach's α=0.85-0.94) and good test-retest reliability (intraclass correlation coefficient=0.77-0.92). Correlations of the LSRS with the SF36v2 mental health score (r=0.32, p=0.01) and with the SLS (r=0.27, p=0.04) supported the good convergent validity. The divergent validity was shown by the non-significant correlation of the LSRS with the MC-SDS (r=0.15, p=0.26). Two factors were extracted through factor analysis, which explained 78.63% of the total variance. The three Adult subscales loaded on the first factor and the three Child subscales loaded on the second factor. Results suggest that the Korean version of the LSRS is a reliable and valid tool for examining the sibling relationship.
PMCID: PMC3897695  PMID: 24465149
sibling relationships; validity; reliability; lifespan sibling relationship scale; psychometrics
25.  Reliability and validity of the modified child and adolescent physical activity and nutrition survey (CAPANS-C) questionnaire examining potential correlates of physical activity participation among Chinese-Australian youth 
BMC Public Health  2014;14:145.
To date, few questionnaires examining psychosocial influences of physical activity (PA) participation have been psychometrically tested among Culturally and Linguistically Diverse (CALD) youth. An understanding of these influences may help explain the observed differences in PA among CALD youth. Therefore, this study examined the reliability and predictive validity of a brief self-report questionnaire examining potential psychological and social correlates of physical activity among a sample of Chinese-Australian youth.
Two Chinese-weekend cultural schools from eastern metropolitan Melbourne consented to participate in this study. In total, 505 students aged 11 to 16 years were eligible for inclusion in the present study, and of these, 106 students agreed to participate (21% response rate). Participants completed at 37-item self-report questionnaire examining perceived psychological and social influences on physical activity participation twice, with a test–retest interval of 7 days. Predictive validity, internal consistency and test–retest reliability were evaluated using exploratory factor analyses, Cronbach’s α coefficient, and the intraclass correlation coefficient (ICC) respectively. Predictive validity was assessed by correlating responses against duration spent in self-reported moderate-to-vigorous physical activity (MVPA).
The exploratory factor analysis revealed a nine factor structure, with the majority of factors exhibiting high internal consistency (α ≥ 0.6). In addition, four of the nine factors had an ICC ≥ 0.6. Spearman rank-order correlations coefficients between the nine factors and self-reported minutes spent in MVPA ranged from -0.5 to 0.3 for all participants.
This is the first study to examine the psychometric properties of a potential psychological and social correlates questionnaire among Chinese-Australian youth. The questionnaire was found to provide reliable estimates on a range of psychological and social influences on physical activity and evidence of predictive validity on a limited number of factors. More research is required to improve the reliability and validity of the questionnaire.
PMCID: PMC3924233  PMID: 24512223
Physical activity; Reliability; Adolescents; Chinese-Australians

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