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- Title
Considering the Balance: Development of a Scale to Assess Patient Views on Trade-Offs in Competing Health Outcomes.
- Authors
Case, Siobhan M.; Towle, Virginia R.; Fried, Terri R.
- Abstract
Objectives To describe the development of a scale assessing participant attitudes regarding two commonly encountered trade-offs: quality versus quantity of life and present versus future health. Design Observational cohort study. Setting Community. Participants Three hundred and fifty-seven community-dwelling adults aged 65 and older. Measurements An initial set of 20 items rated on a 5-point Likert scale of agreement was reduced using principal components analysis. Construct validity was evaluated through comparison of the scale with other tools addressing the same trade-offs and analysis of participant characteristics associated with attitudes favoring quality over quantity of life and present over future health. Internal consistency was assessed using Cronbach alpha. Test-retest reliability was assessed using intraclass correlation coefficients ( ICCs). Results The scale consists of two subscales, each addressing one trade-off, with a total of 10 items. All factor loadings were 0.5 and greater, and subscale scores were significantly different ( P ≤ .05) in the expected directions when comparing with other tools and with participant race, education, and religious identity. Internal consistency was good ( Cronbach α 0.85 and 0.84), and test-retest reliability was fair (ICCs 0.63 and 0.47). Subscale score medians fell near the middle of each scale, with narrow interquartile ranges, but more than 15% of the sample scored at an extreme of each subscale. Conclusion This new scale captures views on two common trade-offs in health care. Although test-retest reliability was modest, its high validity suggests that this tool can be used to familiarize people with common trade-offs and further explore influences on attitudes.
- Subjects
CONNECTICUT; CHI-squared test; CONFIDENCE intervals; STATISTICAL correlation; EXPERIMENTAL design; FACTOR analysis; HEALTH status indicators; LIFE expectancy; LONGITUDINAL method; RESEARCH methodology; SCIENTIFIC observation; HEALTH outcome assessment; QUALITY of life; RESEARCH evaluation; RESEARCH funding; SCALE analysis (Psychology); STATISTICS; T-test (Statistics); U-statistics; DATA analysis; VISUAL analog scale; TREATMENT effectiveness; INTER-observer reliability; MULTITRAIT multimethod techniques; RESEARCH methodology evaluation; PATIENTS' attitudes; DESCRIPTIVE statistics
- Publication
Journal of the American Geriatrics Society, 2013, Vol 61, Issue 8, p1331
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.12358