[국내논문]Psychometric Evaluation of Uterine Cervical Cancer Screening Embarrassment Questionnaire among Korean Women: Complementary Use of Rasch Model원문보기
Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcom...
Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. Methods: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. Results: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. Conclusion: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.
Purpose: Cervical cancer can be prevented by regular cervical screening. Embarrassment has been reported as one important barrier to cervical screening uptake. The absence of appropriate instrumentation, however, has limited our understanding of the links between embarrassment and health care outcomes. The purpose of this study was to evaluate psychometric attributes of the uterine cervical cancer screening embarrassment questionnaire. Methods: A convenience sample for field study was recruited from four gynecological clinics in Gyeongju, Korea. Within a cross-sectional descriptive design, 339 women who had cervical screening completed self-administered measures of embarrassment including a visual analogue, general medical embarrassment, dispositional embarrassment, and Pap smear related negative emotion. Results: Rasch analysis of items demonstrated the evidence of one-dimensional construct and good 7-point rating scales functioning. Factor analysis revealed that uterine cervical cancer screening embarrassment was comprised of two domains-bodily manifestations and perceiving an undesirable social face. Construct validity was demonstrated by a high subscale-to-subscale correlation. Convergent and discriminant validity was evidenced by significant correlations with a 100 mm VAS scale, general medical embarrassment, and Pap smear related negative emotion. Known-group validity was established by comparing women with high versus low trait embarrassment. Both two sub-scales and overall scale demonstrated good internal reliability. Conclusion: The Uterine uterine cervical cancer screening questionnaire is a reliable and valid instrument suited to assessing the manifestations of embarrassment during screening. The use of instrument can be extended to understand the client's embarrassment undergoing health examinations which require the exposure of their private parts.
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가설 설정
0); Ptmea corr.: the association between the item and the entirely test. The ideal value is≥0.
제안 방법
All consenting participants completed a questionnaire package measuring UCCS embarrassment, general medical embarrassment, dispositional embarrassability, and Pap smear related negative emotion. A demographic questionnaire elicited information regarding self-reported age, education, household income, marital status and employment.
Thus, the validity of measure can be assessed by examining whether all items work together to measure one-dimensional construct. Considering the fact that the UCCSEQ has been the only self-administered measure readily available in this specific area, the current study was carried out to evaluate psychometric properties of the UCCSEQ with complementary use of Rasch model.
To assess the relative independence of the sub-scales, the Pearson correlation coefficients were calculated. Convergent and divergent validity was established by examining the correlations between the UCCSEQ, 100 mm VAS ratings, the MEQ, the SES, and the measure of Pap smear related negative emotions to determine. Known group validity was examined by comparing the CCCES scores of women who were high in SES score vs.
After signing a written informed consent form, women completed a self-rating open-ended and closed questionnaire to assess demographic variables. Immediately after her UCCS, the participants were invited by research assistant into a separated place and left alone to complete the UCCSEQ and related psychometric measures. Participants were given a gift voucher valued of US＄5 for completion of the survey.
, 2007). In this study, women were asked to rate their embarrassment during hypothetical medical examinations in which their sexual/reproductive organs and private parts were exposed, touched, and discussed in front of health care providers. Although promising, the items in this questionnaire do not assess the specific manifestations of reactive bodily embarrassment nor are they specific to gynecological examinations.
Convergent and divergent validity was established by examining the correlations between the UCCSEQ, 100 mm VAS ratings, the MEQ, the SES, and the measure of Pap smear related negative emotions to determine. Known group validity was examined by comparing the CCCES scores of women who were high in SES score vs. those who had low score of SES. All statistical analyses were conducted using SPSS version 18.
The Susceptibility to Embarrassment Scale (SES) is a 25-item self report scale measuring broader dispositional embarrassability characteristics (Kelly & Jones, 1997). Participants were asked to rate each of the 25 items on a 7-point Likert scale, ranging from not at all true to exactly true, to test whether UCCS embarrassment was distinct from dispositional embarrassment. This scale has been shown to have good internal reliability with a ⍺ values between .
The participants were asked to make ratings of pre, during, and post-Pap smear embarrassment on the 100mm VAS for convergent validity; all ratings were made immediately after the screening. In the previous study, single-item scales have been used to rate the extent of embarrassment during pelvic examination (Cho & Chung, 2002-b; Patton et al.
The purpose of this study was to describe both the psychometric properties of self-administered UCCSEQ and the function of 7-point rating categories. The preliminary items pool was found to be a unidimensional set for UCCSE measurement and successfully functioned with the 7-point rating categories.
대상 데이터
The reason for the selection of sampling site was to collect the data of public and private UCCS. A total of 380 women were eligible to participate in this study and 339 (82.9%) women gave informed consent. Of these, 16 failed to complete the survey adequately and, as a result, the data from 323 women providing complete data was included in the final analysis.
9%) women gave informed consent. Of these, 16 failed to complete the survey adequately and, as a result, the data from 323 women providing complete data was included in the final analysis.
Participants were eligible for the validation study if they were aged above 20 years, not pregnant, had not received an abnormal UCCS result in the last 6 months and had not a hysterectomy. The sample was recruited from four clinical sites: one gynecologic clinic and health screening center at one university hospital and two other out-patients based gynecologic clinics, in Gyeongju. The reason for the selection of sampling site was to collect the data of public and private UCCS.
데이터처리
Cronbach’s ⍺ coefficients were calculated to establish internal reliability in the sub-scales and in the total 29-item scale. To assess the relative independence of the sub-scales, the Pearson correlation coefficients were calculated. Convergent and divergent validity was established by examining the correlations between the UCCSEQ, 100 mm VAS ratings, the MEQ, the SES, and the measure of Pap smear related negative emotions to determine.
이론/모형
Thus, the underlying assumption tested was that the UCCS embarrassment being measured and the items included in the scale form one-dimensional construct. In this study, the construct of UCCS embarrassment was assessed by Rasch model, which has been known to be as a complementary method to the classical test theory (CTT). The critical problem with the classical test theory (CTT) is that it implies that one can directly infer, e.
성능/효과
As expected (Table 5), women reporting higher trait embarrassability (with mean score ≥ 79 on SES) scored higher than those with lower trait embarrassability (with mean score <79 on SES), indicating that the UCCSEQ had good known-group validity.
As hypothesized, UCCS embarrassment was multi-componential and could be explained by two distinctive, reliable, and valid properties-one circumscribing bodily embarrassment across a range of behavioral and physiological impediment and the other representing women’s apprehension of unwanted public face.
Consequently, a preliminary solution of three correlated factors were selected as the best fit to the data base d on eigen values ≥1 in which all communalities were above .30 and all items loaded at least .40 on only one factor.
Each item is rated using 7-point Likert scales, ranging from 1, ‘not at all’ to 7, ‘a very great deal’, with lower scores indicating feel less embarrassed.
First, dispositional embarrassment was more strongly correlated with ‘bodily predicament’ factor than to the ‘apprehension of undesirable social face’ factor(Table 4).
It was hypothesized that women showing high dispositional embarrassability, in comparison to those with a low score, would feel more embarrassment during UCCS. As expected (Table 5), women reporting higher trait embarrassability (with mean score ≥ 79 on SES) scored higher than those with lower trait embarrassability (with mean score <79 on SES), indicating that the UCCSEQ had good known-group validity.
As expected, the two factors of the UCCSEQ were related to one another and showed a pattern of relations with other measures indicating convergent as well as discriminant validity. Our expectation, that the two factors of the UCCSEQ would be positively associated with the 100 mmVAS, general medical embarrassment, Pap smear related negative emotion and, to lesser degrees, dispositional embarrassment was confirmed (Table 4), with associations being stronger for conceptually more similar constructs. For example, correlations with other related measures of embarrassment ranged from .
Subscale-to-subscale and subscale-to-Overall UCCSEQ correlations were in the expected direction and of general magnitude (F1-F2: r=.71, p<.001; F1 & Overall UCCSEQ: r=.96, p<.001 and F2 & Overall UCCSEQ: r=.87, p<.001), indicating that the UCCSEQ had good construct validity.
후속연구
With a valid measure for UCCS embarrassment, embarrassment as an important barrier for gynecological screening can be reliably assessed and women at-risk for cervical cancer can be identified for appropriate uptake or referrals. In addition, a reliable and valid instrument is needed for use in research to determine incidence, prevalence, and risk factors related with embarrassment.
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