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1.  The function of medication beliefs as mediators between personality traits and adherence behavior in people with asthma 
Background
There is evidence that both personality traits and personal beliefs about medications affect adherence behavior. However, limited research exists on how personality and beliefs about asthma medication interact in influencing adherence behavior in people with asthma. To extend our knowledge in this area of adherence research, we aimed to determine the mediating effects of beliefs about asthma medication between personality traits and adherence behavior.
Methods
Asthmatics (n=516) selected from a population-based study called West Sweden Asthma Study completed the Neuroticism, Extraversion and Openness to Experience Five-Factor Inventory, the Medication Adherence Report Scale, and the Beliefs about Medicines Questionnaire. Data were analyzed using confirmatory factor analysis and structural equation modeling.
Results
Three of the five investigated personality traits – agreeableness, conscientiousness, and neuroticism – were associated with both concerns about asthma medication and adherence behavior. Concerns functioned as a partial mediator for the influencing effects of agreeableness, conscientiousness, and neuroticism on adherence behavior.
Conclusion
The findings suggest that personality traits could be used to identify individuals with asthma who need support with their adherence behavior. Additionally, targeting concerns about asthma medication in asthmatics with low levels of agreeableness or conscientiousness or high levels of neuroticism could have a favorable effect on their adherence behavior.
doi:10.2147/PPA.S49725
PMCID: PMC3808229  PMID: 24174872
adherence; individual differences; medication concerns; health behavior
2.  Translation and testing of the Risk Assessment Pressure Ulcer Sore scale used among residents in Norwegian nursing homes 
BMJ Open  2012;2(5):e001575.
Objective
The purpose of this study was to translate and test the psychometric properties of the Norwegian-language version of the Risk Assessment Pressure Sore (RAPS) scale.
Background
Risk assessment scales for pressure ulcer (PU) prevention have become an aspect of quality improvement in healthcare, but their effectiveness depends on the reliability and validity of the scale.
Methods
 A convenience sample of 481 residents in 15 nursing homes in rural Norway was included between January and June 2007. The English-language version of the RAPS scale was translated into Norwegian, and this scale was used to collect the data, including a skin examination. The number of PUs and grades were documented. Reliability was assessed in a small group of 26 residents and construct validity in the total study group.
Results
Equivalence between two assessments regarding total scores of the RAPS scale was reflected in an intraclass correlation coefficient (ICC) of 0.95. Construct validity was supported, and the RAPS scale could define groups with expected low and high scores. Further evidence of construct validity was shown in a confirmatory factor analysis.
Conclusion
The Norwegian version of the RAPS scale has shown sufficient psychometric properties to be considered a reliable and valid scale for identifying risk of PUs among nursing home residents. However, further testing is needed.
doi:10.1136/bmjopen-2012-001575
PMCID: PMC3488716  PMID: 23100445
WOUND MANAGEMENT
3.  Construct validity of the Moral Development Scale for Professionals (MDSP) 
The aim of this study was to investigate the construct validity of the Moral Development Scale for Professionals (MDSP) using structural equation modeling. The instrument is a 12-item self-report instrument, developed in the Scandinavian cultural context and based on Kohlberg’s theory. A hypothesized simplex structure model underlying the MDSP was tested through structural equation modeling. Validity was also tested as the proportion of respondents older than 20 years that reached the highest moral level, which according to the theory should be small. A convenience sample of 339 nursing students with a mean age of 25.3 years participated. Results confirmed the simplex model structure, indicating that MDSP reflects a moral construct empirically organized from low to high. A minority of respondents >20 years of age (13.5%) scored more than 80% on the highest moral level. The findings support the construct validity of the MDSP and the stages and levels in Kohlberg’s theory.
doi:10.2147/JMDH.S20075
PMCID: PMC3104688  PMID: 21655343
Kohlberg; scale testing; simplex structure model; structural equation modeling

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