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A Psychometric Toolbox for Testing Validity and Reliability
Abstract
Purpose To review the concepts of reliability and validity, provide examples of how the concepts have been used in nursing research, provide guidance for improving the psychometric soundness of instruments, and report suggestions from editors of nursing journals for incorporating psychometric data into manuscripts. Methods CINAHL, MEDLINE, and PsycINFO databases were searched using key words: validity, reliability, and psychometrics. Nursing research articles were eligible for inclusion if they were published in the last 5 years, quantitative methods were used, and statistical evidence of psychometric properties were reported. Reports of strong psychometric properties of instruments were identified as well as those with little supporting evidence of psychometric soundness. Findings Reports frequently indicated content validity but sometimes the studies had fewer than five experts for review. Criterion validity was rarely reported and errors in the measurement of the criterion were identified. Construct validity remains underreported. Most reports indicated internal consistency reliability (alpha) but few reports included reliability testing for stability. When retest reliability was asserted, time intervals and correlations were frequently not included. Conclusions Planning for psychometric testing through design and reducing nonrandom error in measurement will add to the reliability and validity of instruments and increase the strength of study findings. Underreporting of va…
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“Questions were derived from the two previous studies on the topic (Wilson et al. 2010(Wilson et al. , 2013)), thus contributing to both content and face validity (DeVon et al. 2007).”
From Understanding skill acquisition among registered nurses: the ‘perpetual novice’ phenomenon (2015) · cites this paper as DeVon et al. 2007
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“These measures ensured the questionnaire’s content and face validity.[19] Pilot‐testing of the questionnaire was also carried out among 30 participants.”
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“Face validity indicates the extent to which questionnaires appear to be suitable to a study’s purpose and is considered as the weakest form of validity (DeVon et al., 2007; Haladyna, 1999; Trochim, 2001).”
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Cross-cultural adaptation and validation of the neonatal/infant Braden Q risk assessment scale.
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“The multidisciplinary group established by consensus that the instrument had face validity, measuring the risk of a neonate developing pressure ulcers it intends to measure, as well as content validity, meaning that each subscale was considered relevant in measuring the risk of pressure ulcers in neonates [26].”
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“Exploratory factor analysis (EFA) was used to demonstrate overall construct validity (i.e. convergent and divergent validity; Burns & Grove, 2005; DeVon et al., 2007; Roberts, Priest, & Traynor, 2006).”
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Turkish adaptation of the state–trait anxiety inventory short version (STAIS‐5, STAIT‐5)
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Development and standardization of the work-life balance scale for the insurance sector employees
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Household Emergency Preparedness Instrument Development: A Delphi Study
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“Internal consistency of the items in the scale was assessed using Cronbach's alpha coefficients and item analysis (item to total, r) (DeVon et al., 2007).”
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“Convergent validity describes the extent to which scores produced by a new instrument are correlated with scores on comparable (or conceptually identical) existing instruments (DeVon et al. 2007).”
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Cross-Cultural Adaptation, Validity and Reliability of the Escala Pessoal de Resultados
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“Reliability estimates the level which a scale is consistent, free from random error and reproducible (Andresen 2000; DeVon et al. 2007; Hartley and MacLean 2006; Li et al. 2013; Noonan et al. 2009; Robinson et al. 1991; Schalock et al. 2007).”
BackgroundHow to read and critically appraise a reliability article
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“Therefore, the time period between measurements needs to be suf-fi ciently long to reduce the possibility of recall (and to reduce the likelihood of the increase in pain intensity), but short enough to reduce the risk of a change in health status (DeVon et al, 2007).”
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Gazzaz, N. M., & Aldeseet, B. A. (2021) · World Journal of Education · doi:10.5430/wje.v11n5p41 · Cited by 31
Developing and validating the Menopausal Spousal Support Questionnaire (MSSQ) for menopausal women
Hassan, I. I., Hussain, N. H. N., Zaharah, S., Kadir, A. A., & Zarawi, M. N. M. (2021) · Maturitas · doi:10.1016/j.maturitas.2021.10.005 · Cited by 23
Mehta, P., Singh, M., Mittal, M., & Singla, H. (2021) · Qualitative Research in Financial Markets · doi:10.1108/qrfm-11-2020-0218 · Cited by 20
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“According to (DeVon et al., 2007; Trochim & Donnelly, 2001), face validity evaluates the appearance of the questionnaire in terms of consistency of style and formatting, the clarity of the language used, and readability.”
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Reliability and Validity of the 4‐Item Version of the Korean Perceived Stress Scale
Kim, H. (2016) · Research in Nursing & Health · doi:10.1002/nur.21745 · Cited by 21
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“SDE was lower than expected, but other values were higher than the approved value of 0.70 (DeVon et al., 2007).”
ResultInfluentialRosenkranz, R. R., Duncan, M. J., Caperchione, C. M., Kolt, G. S., Vandelanotte, C., Maeder, A. J., Savage, T. N., & Mummery, W. K. (2015) · BMC Public Health · doi:10.1186/s12889-015-2539-y · Cited by 17
“Concurrent criterion-related validity refers to the correspondence between scores from two instruments that were measured at the same point in time [34].”
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“A project team member recorded any questions/comments about clarity of items, grammar, syntax, organization, appropriateness, acceptability to staff, ease of use, and logical flow [12].”
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“Face validity indicates that the items appear to be appropriate to the study purpose and content area [20].”
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“In other words, their meaning and relevance are obvious, and that on the ‘‘face’’ of it, they measure the construct of interest [40].”
BackgroundManaging visitor experience at religious heritage sites
Pande, K., & Shi, F.-F. (2023) · Journal of Destination Marketing & Management · doi:10.1016/j.jdmm.2023.100800 · Cited by 20
Krohne, N., Gomboc, V., Lavrič, M., Podlogar, T., Poštuvan, V., Šedivy, N. Z., & Leo, D. D. (2022) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580211047193 · Cited by 22
“We further determined construct validity through hypothesis testing.(24) More specifically, we conducted a correlational analysis to examine the relationship of the S-MHLS factors with related constructs.”
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“Expert panels are often sought to review tools for logical flow, organisation, grammar and suitability for face validity (DeVon et al., 2007).”
BackgroundQuantity over quality: Do single-item scales reflect what users truly experienced?
Cuvillier, M., Léger, P., & Sénécal, S. (2021) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2021.100097 · Cited by 22
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Translation and cultural adaptation of the Sensory Profile 2 to the Persian language
Shahbazi, M., Mirzakhani, N., Zarei, M. A., Zayeri, F., & Daryabor, A. (2021) · British Journal of Occupational Therapy · doi:10.1177/0308022621991768 · Cited by 18
“The assessment of content validity by the panel of experts was analyzed by calculating the CVI (DeVon et al., 2007).”
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Inter-rater reliability and concurrent validity of ROBINS-I: protocol for a cross-sectional study
Jeyaraman, M. M., Rabbani, R., Al‐Yousif, N., Robson, R. C., Copstein, L., Xia, J., Pollock, M., Mansour, S., Ansari, M., Tricco, A. C., et al. (2020) · Systematic Reviews · doi:10.1186/s13643-020-1271-6 · Cited by 23
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Resilience in Koreans With Cancer
Lee, S., Lee, H., Fawcett, J., & Park, J. H. (2019) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0000000000000543 · Cited by 32
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Psychometric evaluation of the McCloskey/Mueller Satisfaction Scale.
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Self-Neglect: Development and Evaluation of a Self-Neglect (SN-37) Measurement Instrument.
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“Face validity is based on assessment of experts of how clearly items on the scale reflected the concept beingmeasured (Devon et al., 2007; Polit & Beck, 2010).”
BackgroundDescribing the role of Australian community pharmacists in oral healthcare
Taing, M., Ford, P. J., GARTNER, C. E., & Freeman, C. R. (2016) · International Journal of Pharmacy Practice · doi:10.1111/ijpp.12241 · Cited by 32
“9).([31]) Due to publishing the survey on PSA social media forums and the AusPharmList, it was not possible to determine the overall participant response rate due to broad dissemination and the potential for respondents to disseminate the survey link to community pharmacists not associated with these professional phar…”
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“This indicated how well the items fitted together conceptually.[33,36] All items with item‐total correlations <0.”
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“The most commonly used statistical method to determine the internal consistency is calculating the Cronbach’s alpha coeYcient [3].”
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“Guided by the COSMIN guidelines, we made the following hypotheses regarding construct validity [84, 85]: 1) The PHQ-4-SC would positively correlate (0.300– 0.500) with the SRHQ, as both measure related constructs but the SRHQ tends to focus more on health conditions.”
BackgroundMethodInfluentialYang, Q., Cheng, H., Qin, J., Loke, A., Ngai, F.-W., Chong, K., Zhang, D.-X., Gao, Y., Wang, H., Liu, Z., et al. (2023) · JMIR Aging · doi:10.2196/46791 · Cited by 19
Development and validation of a short-form suboptimal health status questionnaire
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“The Kaiser–Meyer–Olkin (KMO) value and Bartlett’s test of sphericity were used to assess the suitability of EFA; if the KMO value is ≥ 0.60 and Bartlett’s test of sphericity is significant ( p < 0.05), then EFA is appropriate [34, 35].”
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“We use a framework described in “A Psychometric Toolbox for Testing Validity and Reliability” (DeVon et al. 2007), although we make no claim that this work is the definitive approach to establishing validity.”
MethodMeasuring Learning and Engagement during Debriefing: A New Instrument
Reed, S. J. (2020) · Clinical Simulation in Nursing · doi:10.1016/j.ecns.2020.03.002 · Cited by 21
Jeannot, R., Ravelomanantsoa, J. J., & Razanamihaja, N. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01296-1 · Cited by 19
“1) measured the differences between contrasting groups of participants, 2) reflected the framework hypothesized in a hypothesis testing study, and 3) could undergo a confirmatory factor analysis that adequately establishes that the measurement model fitted the actual data [34].”
MethodDevelopment and validation of elder-friendly urban spaces questionnaire (EFUSQ)
Lak, A., Aghamolaei, R., Baradaran, H. R., & Myint, P. K. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1355-0 · Cited by 22
Development of a Clinical Teaching Evaluation and Feedback Tool for Faculty
Dehon, E. E., Robertson, E. M., Barnard, M., Gunalda, J. C., & Puskarich, M. A. (2018) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2018.11.39987 · Cited by 18
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“The CVI is the mean CVR for all the items included in the final instrument [33].”
BackgroundInstrument Development and Testing for Selection of Nursing Preceptors
Cotter, E., Eckardt, P. A., & Moylan, L. B. (2018) · Journal for Nurses in Professional Development · doi:10.1097/nnd.0000000000000464 · Cited by 26
How to decide which patient-reported outcome measure to use? A practical guide for plastic surgeons
Dobbs, T. D., Hughes, S., Mowbray, N. G., Hutchings, H. A., & Whitaker, I. S. (2018) · Journal of Plastic Reconstructive & Aesthetic Surgery · doi:10.1016/j.bjps.2018.03.007 · Cited by 25
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“According to (DeVon et al. (2007), the claims of content validity of published instruments have been criticized as lacking information regarding a specified method.”
Bakanauskienė, I., Bendaravičienė, R., & Barkauskė, L. (2017) · doi:10.21511/ppm.15(2).2017.01 · Cited by 19
“It can be seen from the data in Table 5, that only 2% (20) of employees gave their employers the score from 1 to 4 in a 10-point response scale (with 1 meaning “not attractive” at all and 10 meaning “very attractive”), percibing them as not attractive working places.”
BackgroundA systematic review on validity evidence of Medical Student Stressor Questionnaire
Yusoff, M. S. B. (2017) · doi:10.5959/eimj.v9i1.510 · Cited by 19
“The clarity of language and comprehensibility of sentences used in MSSQ will ensure exclusion of any misperceptions between developers and users on the items structure (53).”
MethodMeasurement Reliability of Phonation Quotient Derived From Three Aerodynamic Instruments.
Joshi, A., & Watts, C. R. (2016) · Journal of Voice · doi:10.1016/j.jvoice.2015.11.015 · Cited by 19
The Portuguese Version of Personal Outcomes Scale: A Psychometric Validity and Reliability Study
Simões, C., Santos, S., & Claes, C. (2015) · Intellectual and developmental disabilities · doi:10.1352/1934-9556-53.2.129 · Cited by 19
“…that these unretained items had salient loadings on two or more factors (Brown, 2006), with values $ .32 on at least two factors (Costello & Osborne, 2005; Worthington & Whittaker, 2006), or failed to exceed the cut-off point of .40 (DeVon et al., 2007; Henson & Roberts, 2006; Matsunaga, 2010).”
BackgroundMethodMeasuring First-Line Nurse Manager Work: Instrument Development and Testing
Cadmus, E., & Wisniewska, E. K. (2013) · Journal of Nursing Administration · doi:10.1097/nna.0000000000000010 · Cited by 19
“Content validity refers to the degree to which the instrument measures what it is intended to measure based on the judgment of experts.(23,24) A review of current literature, 2 focus groups of FLNMs (n = 10), and a review by CNOs (n = 5) were used to establish the content validity of the survey instrument.”
MethodYilmaz, O., Gul, E., & Bodur, H. (2013) · Rheumatology International · doi:10.1007/s00296-013-2854-5 · Cited by 19
Hotel employees’ intention not to waste food: The role of environmental concern
Elkhwesky, Z., Castañeda-García, J.-A., Manzani, Y. E., Rehman, S. U., & Hassan, H. M. (2024) · Current Psychology · doi:10.1007/s12144-024-05952-3 · Cited by 24
“According to DeVon et al. (2007), face validity is essential for evaluating the appropriateness and relevance of questions and improving the instrument (Bolarinwa, 2015).”
Mahmoodi, M., Hejazi, N., Bagheri, Z., Nasimi, N., Clark, C. C. T., Moosavi, M., Dabbaghmanesh, M. H., & Mazloom, Z. (2022) · Aging Clinical and Experimental Research · doi:10.1007/s40520-022-02255-0 · Cited by 17
“This method is a proportional level of agreement on how many proficient have graded an item “It is necessary” [27, 29].”
BackgroundMethodCampbell, E., Jessee, D., Whitney, J., Vupputuri, S., & Carpenter, J. (2021) · Journal of Emergency Nursing · doi:10.1016/j.jen.2021.04.011 · Cited by 18
Research on the Sustainability of the Standard Gauge Railway Construction Project in Tanzania
Wang, J., Sekei, V. S., Ganiyu, S. A., & Makwetta, J. J. (2021) · Sustainability · doi:10.3390/su13095271 · Cited by 18
“Cronbach alpha is favored over composite reliability because it has a lower bias estimation of internal accuracy [37].”
BackgroundDevelopment and validation of an instrument to assess quality physical education
Ho, W. K. Y., Ahmed, M. D., & Kukurová, K. (2021) · Cogent Education · doi:10.1080/2331186x.2020.1864082 · Cited by 39
The impact of teaching experimental research on-line: Research-informed teaching and COVID-19
Higgins, R., Murphy, F., & Hogg, P. (2020) · Radiography · doi:10.1016/j.radi.2020.11.014 · Cited by 21
Tohmola, A., Saarnio, R., Mikkonen, K., Kyngäs, H., & Elo, S. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14609 · Cited by 18
Development and psychometric evaluation of the healthy lifestyle questionnaire for elderly (heal)
Bandari, R., Shahboulaghi, F. M., & Montazeri, A. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01529-3 · Cited by 18
Clutter negotiating ability in an ensemble of forest interior bats is driven by body mass
Senawi, J., & Kingston, T. (2019) · Journal of Experimental Biology · doi:10.1242/jeb.203950 · Cited by 22
“The value of Cronbach’s α ranges from 0 to 1 in which the higher values indicate a more reliable scale (DeVon et al., 2007).”
BackgroundMethodValidation of the Neck Disability Index in Serbian Patients With Cervical Radiculopathy
Jovičić, M. D., Konstantinović, L. M., Grgurević, A., Milovanovic, N. D., Trajković, G., Jovičić, V., Kostic-Dedic, S., Hrković, M., & Draganac, S. M. (2018) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2017.10.018 · Cited by 17
He, S., Wang, J. H., & Ji, P. (2017) · Journal of Oral Rehabilitation · doi:10.1111/joor.12591 · Cited by 22
An Initial Psychometric Evaluation of the Joint Attention Protocol
Nowell, S. W., Watson, L. R., Faldowski, R. A., & Baranek, G. T. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3458-9 · Cited by 20
“Authors in disciplines such as speech-language pathology (Friberg 2010; McCauley and Swisher 1984; Plante and Vance 1994), healthcare (DeVon et al. 2007; Kottner et al. 2011), and psychology (Cicchetti 1994; Furr 2011) have proposed guidelines for clinical evaluation of measurement quality.”
BackgroundDevelopment of the Korean Paternal-Fetal Attachment Scale (K-PAFAS)
Noh, N. I., & Yeom, H.-A. (2017) · Asian Nursing Research · doi:10.1016/j.anr.2017.05.001 · Cited by 18
Huddleston, P., Mancini, M., & Gray, J. A. (2017) · Journal of Nursing Administration · doi:10.1097/nna.0000000000000456 · Cited by 18
Health Literacy Tool Shed: A Source for Validated Health Literacy Instruments
Harnett, S. (2017) · doi:10.1080/15398285.2017.1280344 · Cited by 18
“…with reliability scores as a measure of Cronbach’s alpha, as “the degree to which an instrument measures the construct it is intended to measure” (DeVon et al. 2007, 156), or test-retest, in which reliability is a measure of the correlation between a test administered to a group at different…”
BackgroundMethodInfluentialDevelopment and psychometric testing of a breast cancer patient-profiling questionnaire
Gorini, A., Mazzocco, K., Gandini, S., Munzone, E., Mcvie, G. J., & Pravettoni, G. (2015) · Breast Cancer Targets and Therapy · doi:10.2147/bctt.s80014 · Cited by 22
“Phase 2: construct validity and internal consistency reliability Construct validity answers the question of whether or not the items of an instrument consistently, and with sufficient precision, measure the construct they are supposed to measure.(17,18) The sample for factor analysis included 100 Italian women operate…”
Mulder, P., & Johnson, T. (2010) · Research in Nursing and Health · doi:10.1002/nur.20384 · Cited by 18
The PMA scale: a measure of physicians' motivation to adopt medical devices
Hatz, M. H. M., Sonnenschein, T., & Blankart, C. R. (2017) · Value in Health · doi:10.1016/j.jval.2016.12.002 · Cited by 20
“[41] DeVon HA, Block ME, Moyle-Wright P, et al.”
BackgroundMethodInfluentialJiang, C., Sun, J., Lv, Y., Hu, S. T., Cheng, W., Zhao, X., Zheng, Y., Wu, X., & Lv, L.-Q. (2024) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2024.11.008 · Cited by 18
Validating Student’s Green Character Instrument Using Factor and Rasch Model
Sukri, A., Arief, M., Purwanti, E., Ramdiah, S., & Lukitasari, M. (2022) · European Journal of Educational Research · doi:10.12973/eu-jer.11.2.859 · Cited by 17
“Furthermore, from the four criteria, dichotomous data was made to measure content validation using the content validity index method (Polit & Beck, 2006) with the provisions that CVI values > 0.79 were accepted, CVI values 0.70-0.79 were revised, and CVI < 0.70 were rejected (Devon et al., 2007).”
MethodInfluentialOsman, K., Sovey, S., & Matore, M. E. E. M. (2022) · Eurasia Journal of Mathematics Science and Technology Education · doi:10.29333/ejmste/11794 · Cited by 27
“Thus, the findings emphasize construct validity, or the degree to which the questions on an instrument correspond to the corresponding theoretical construct (DeVon et al., 2007).”
BackgroundA User Experience Questionnaire for VR Locomotion: Formulation and Preliminary Evaluation
Boletsis, C. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-58465-8_11 · Cited by 23
“Content validity can be assessed through literature reviews, expert opinions, population sampling, and qualitative research [3, 15], the latter being the case herein.”
BackgroundDevelopment and Validation of an Atrial Fibrillation Knowledge Assessment Tool (AFKAT)
Abubakar, I. J., Wimmer, B. C., Bereznicki, L., Dwan, C. A., Black, J. A., Bezabhe, W. M. M., & Peterson, G. M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17051721 · Cited by 23
“Construct validity was determined using a contrast group approach by comparing the mean knowledge scores of the four study sub-groups [21].”
BackgroundMethodInfluentialA psychometric evaluation of the Chinese version of the Nursing Home Adjustment Scale
Xiao, H.-M., Yong, B., Liu, X.-P., & Lin, Y. (2019) · Quality of Life Research · doi:10.1007/s11136-019-02192-y · Cited by 17
Ernst, M. M., Gardner, M., Mara, C. A., Délot, E. C., Fechner, P. Y., Fox, M., Rutter, M. M., Speiser, P., Vilain, E. J. N., Weidler, E. M., et al. (2018) · Hormone Research in Paediatrics · doi:10.1159/000496114 · Cited by 20
Bodell, L. P., Forney, K. J., Chavarria, J., Keel, P., & Wildes, J. (2018) · International Journal of Eating Disorders · doi:10.1002/eat.22957 · Cited by 17
Metadata
- Authors
- DeVon, H. A., Block, M. E., Moyle‐Wright, P., Ernst, D. M., Hayden, S. J., Lazzara, D. J., Savoy, S. M., & Kostas‐Polston, E.
- Affiliations
- Purdue University Northwest (US)
- Corresponding author
- DeVon, Holli A.
- Block, Michelle E.
- Moyle‐Wright, Patricia
- Ernst, Diane M.
- Hayden, Susan J.
- Lazzara, Deborah J.
- Savoy, Suzanne M.
- ORCID
- DeVon, Holli A.
- Venue
- Journal of Nursing Scholarship
- Publisher
- Wiley
- Published
- 2007-05-23
- Volume
- 39
- Issue
- 2
- Pages
- 155-164
- ISSN
- 0363-2792 (ISSN-L)
- 1527-6546
- 1547-5069
- OpenAlex
- W2162602057
- Cited by
- 1,889
- References
- 0
- Citations by year
- 2026: 87 · 2025: 128 · 2024: 186 · 2023: 176 · 2022: 148 · 2021: 163 · 2020: 145 · 2019: 144 · 2018: 131 · 2017: 113 · 2016: 96 · 2015: 105 · 2014: 83 · 2013: 51 · 2012: 40
- FWCI
- 15.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Nursing Scholarship (publishedVersion)
- PubMed (publishedVersion)
- ePublications at Regis University (Regis University) (submittedVersion)
- Topics
- Health Sciences › Nursing › Research and Theory › Health Education and Validation
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Keywords
- psychometric properties, reliability statistics, validity, content validity, criterion validity, construct validity, internal consistency, test-retest reliability, measurement error, nursing equipment, nursing research
- MeSH terms
- Data Interpretation, Statistical, Factor Analysis, Statistical, Humans, Mathematics, Periodicals as Topic, Planning Techniques, Predictive Value of Tests, Psychometrics, Research Design, Time Factors, Reproducibility of Results, Nursing Research, Bias, Discriminant Analysis, Guidelines as Topic, Peer Review, Research, Statistics, Nonparametric, Editorial Policies
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