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A self-report scale to assess the perceptions of patients undergoing radio-diagnostic towards the procedures (CT/MRI)

Date of last revision January 28, 2011

Introduction

Radio-diagnostic procedures (CT/MRI) are common investigations done in hospital settings. A layman who is undergoing a radiodiagnostic procedure may have different perceptions regarding the procedure. It is the responsibility of health professionals to inform the patient about the procedure at patient’s level of understanding. Patients perceive the procedure in different ways. By developing a self-report scale to assess the perceptions of patients posted for radio diagnostic procedure, the aim was to facilitate free expression of patients’ misperceptions about the procedure. This will help the health team members to identify the sensitive areas where they have to give more attention when preparing the patients for diagnostic procedures. 

Objectives

  • To develop a self-report scale to assess perceptions of patients undergoing radio-diagnostic towards the procedures (CT/MRI)

  • To establish content validity of the self-report scale  

  • To establish reliability of the self-report scale in terms of internal consistency     

Procedure for tool development

  • Due to non-availability of a relevant standardized research tool, the researchers constructed a tool based on study objectives.

  • The tool was developed by investigators after reviewing related research studies and discussion with faculty.

  • A blue print was prepared for the tool on perceptions of patients posted for radio diagnostic procedures (CT/MRI).

  • The tool developed was a self-report scale to assess perceptions of patients posted for radio diagnostic procedures (CT/MRI).

Description of the tool

  • The tool can be administered in patients who are posted for radio-diagnostic procedures, especially (CT/MRI).

  • Candidates were instructed to mark ‘Yes’ if they ‘agree’ with the statement and ‘No’ if the ‘disagree’ with the statement

  • If the patient is giving a positive response to a negative item, it is the responsibility of the researcher/investigator to explain the true information and clarify doubts.

  • Initially, the number of items in the tool was 15, which include both positive and negative items.

  • 3 items were included later as experts suggested.

  • We considered items 1, 7,10,17,18 positive items and 2,3,4,5,6,7,8,11,12,13,14,15,16 were negative.

Sr. No

Items

Yes

No

1

The procedure will help to find out the cause of my illness

 

 

2

I am afraid to undergo the procedure

 

 

3

I am anxious about the result of the procedure

 

 

4

I will be made unconscious when undergoing the procedure

 

 

5

It is not necessary to undergo this procedure

 

 

6

This procedure is a treatment method

 

 

7

This procedure is done because my doctor has told to do it

 

 

8

I wish my relative is allowed to stay with me during the procedure

 

 

9

This procedure will cure my illness

 

 

10.   

This procedure will not cause any harm to me

 

 

11.   

This is a painful procedure

 

 

12.   

In this procedure electric current is passed in to the body

 

 

13.   

This procedure will have some adverse effects in later life

 

 

14.   

This procedure is advised in severe illness only

 

 

15.   

This procedure is a surgical operation

 

 

Added Later

This procedure is likely to damage the healthy tissue of my body

 

 

Added Later

I have been adequately explained about the procedure

 

 

Added Later

This procedure is expensive

 

 

 Scoring of the tool:

  • Responses to individual items should be interpreted separately to understand the person’s perceptions to the particular item.

  • For the purpose of establishing reliability a total score was generated for each sample.

  • Each response was given an option of Yes/No.

  • Positive items were scored as Yes-1 and No- 0 and the negative items were scored as Yes-0 and No-1.

  • In future use we suggest, association of the total scores with socio demographic variable should be considered.

Content validity

  • Validity refers to the degree to which an instrument measures what it is intended to measure.
  • To ensure content validity, the tools along with blue print, objectives and criteria check list were submitted to 7 experts.
  • The experts were requested to give their opinion & suggestion on relevancy, accuracy and appropriateness of the items.

Question

Agreement

Disagreement

1

80%

20%

2

100%

-

3

100%

-

4

80%

20%

5

80%

20%

6

100%

 

7

100%

 

8

80%

20%

9

100%

 

10

100%

 

11

100%

 

12

100%

 

13

100%

 

14

100%

 

15

100%

 

As two experts suggested, 3 additional items were included. Scoring pattern was changed to dichotomous answering pattern.

Language validity

  • The tool was translated to Kannada by a professional and language expert.
    Face validity of the translated tool was done.

Interpretation of Validity

  • All the experts agreed on all the items. Adequate level of validity was established.

Reliability

  • Reliability of an instrument is the degree of consistency with which it measures the attribute it is supposed to be measuring.

Procedure for data collection

Data collection is a process of acquiring subjects and collecting information needed for the study. The tool was administered to 20 patients who are posted for radio diagnostic procedures (CT/MRI), on 4th and 5th of June’08. The responses were tabulated and data was analyzed. Reliability co efficient for internal consistency was computed using Kuder Richardson method manually and using SPSS program.

Formula used for the calculation was Kuder Richardson 21
             KR21= k     [1-m (k-m)]
                      K-1                ks2
Where,
          k = number of items
          m = mean of the test scores
          s = standard deviation of the test scores

Calculation

According to this data:
                    K = 18
                    m= 11.6
                    s = 2.94
Therefore,     KR 21 = 0.5565

Interpretation

  • The reliability obtained was 0.5565

  • Reliability was established using SPSS program and found =0.68

Conclusion

There are various methods of checking validity and reliability of research tools. We have established content validity and internal consistency of the self-report scale, which we have developed. The reliability and validity indexes should be interpreted based on the significance of the problem.

References

  1. Polit DF, Hungler BP. Nursing Research: Principles and Methods. Philadelphia: JB Lippincott Company; 1998.

  2. Burns N, Grove SK. The practice of Nursing Research. 4th Ed. Philadelphia: WB Saunders Publications; 2001.  

  3. Treece JW, Treece EW. Elements of Research in Nursing (3rded.). St. Louis: Mosby; 1982.

 

 
 
 
 
           
 

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