WFOT 2018 progress 3

炫文及芳瑜：
各10篇相關文章；下周確認【結果】內容。

me, CFA data analysis確認。

3/1研究計畫撰寫課程：以自身計畫為主，修正計畫撰寫。

RSFS CFA & Ruff27 practice effect_撰寫進度總表

RSFS CFA
1. 2/12, methods.
2. 2/13, methods revised. Q: (1)以CFA, GLM關鍵字尋找model paper, 建立【結果】之內容。
3. 2/22, AMOS外掛套件：plugins/pattern matrix model builder 這是一個建立CFA model的選項。
4. 2/23, results prepare. 10 model papers.
5. 3/2, 10 model papers for results.


Ruff27 practice effect
1. 2/15, methods.
2. 2/22, methods revised.
3. 2/23, from ICC to SEM, MDC and practice effect, paired t test, effect size.
4. 3/2, complete table 1 and 2; 10 model papers.

The test-retest reliability and practice effects of the Ruff 2 & 7 Selective Attention Test in patients with schizophrenia

Method

1 Participants

Current Chronic inpatients with schizophrenia were recruited from the chronic wards at Taipei City Hospital, Songde Branch a psychiatric center in northern Taiwan between? and?. (請確認收案期間) The inclusion criteria were as follows: (1) individuals with diagnosed with schizophrenia or schizoaffective disorder which confirmed by treating psychiatrists according to based on Diagnostic and Statistical Manual of Mental Disorder, Text Revision, 4th edition (DSM-4-TR) (4請用羅馬數字)Fifth Edition (DSM-5) (Association, 2013); (2) keeping stable clinical condition and medical treatment (no psychiatric emergency and acute treatment records in the month prior to recruitment) during admission; (3) age more than 20 years old; and (4) agreement to participate this study Mini-mental state examination (MMSE) > 24 points.(?請確認是否有用MMSE評估認知篩檢) We excluded those participants if they showed The exclusion criteria were as follows: (1) schizophrenia with other diagnoses having a secondary diasnosis, such as attention deficit hyperactivity disorder, attention deficit disorder, etc. (ex: depression, anxiety, substance abuse or ADHD, etc.); (2) mental retardation; (3) serious brain injury; and (4) who can’t finish the tests because of cognitive disability, low vision or poor hand function. For test-retest reliability of Ruff 2 & 7 Test, researchers ruled out the score differences of Clinical Global Impression Scale of Severity (CGI-S; Busner & Targum, 2007) more than zero between pre-test and post-test to ensure that each participant was stable in symptom. Written informed consent was obtained from all participants each inpatient before data collection. This study was approving All study procedures were approved by Taipei City Hospital the Research Ethics Committee (No.: TCHIRB-10605103) of the local psychiatric center. (請再次確認IRB編號)

{Association, 2013 #24;Association, 2013 #24}

2 Symptom Measure

The CGI-S is a one-item and seven-point rating scale, usually used to evaluate severity of psychopathology in schizophrenia. The rater scores from 1 (normal) to 7 (among the most extremely in ill patients) according to observed behavior, reported symptom and function in the past seven days. This scale takes the rater only 1-2 minutes. (Busner & Targum, 2007). There are good correlations among in the CGI-S, the PANSS and the PSP (Nafee et al., 2012; Rabinowitz, Mehnert, & Eerderkens, 2006). There is also response in CGI-S (Leucht & Engel, 2005). The CGI-S will used in this study to ensure the participants are stable.

3 Procedure

The Ruff 2 & 7 Test was administered by a specially trained research assistant twice, at an interval of two weeks. The Ruff 2 & 7 Test was implemented in a quiet room without environmental disturbing. After the Ruff 2 & 7 Test finished within 24 hours, every participant would accept the assessment of CGI-S by trained clinical practitioners in mental health. The participants with stable CGI-S scores were included for further data analysis. All above demographic and clinical data was collected by researchers.

4 Data analysis

The Statistical Product and Service Solutions version 21.0 was used to perform statistic analysis.

4.1         Test-retest Reliability

Test-retest reliability was determined by Pearson r. We used the Pearson r to calculate their correlation coefficients that range from -1 to 1. The venue of r between 0 and ±0.25 was lack of correlation; range from 0 to 0.5 or -0.25 to -0.5 mean poor correlation; 0.5 to 0.75 or between -0.75 and -0.5 was good correlation; and range from 0.75 to 1 or -0.75 to -1 was very good correlation.

4.2         Practice Effect

The pair t test and effect size d were used to test. When t value arrive the statistic significance that there are practice effect. d ≧0.2, there is practice effect (Cohen, 1988).

Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Association.

Busner, J., & Targum, S. D. (2007). The Clinical Global Impressions Scale: Applying a Research Tool in Clinical Practice. Psychiatry (Edgmont), 4(7), 28–37.

Lan, C. M., Tsai, P. C., & Tan, M. Y. (2011). Validation of the ruff 2 and 7 selective attention test for outpatients with schizophrenia. Journal of Occupational Therapy Association R.O.C., 29(1), 28-45. doi:10.6594/JTOTA.2011.29(1).02

Leucht, S., & Engel, R. R. (2005). The Relative Sensitivity of the Clinical Global Impressions Scale and the Brief Psychiatric Rating Scale in Antipsychotic Drug Trials. Neuropsychopharmacology, 31, 406. doi:10.1038/sj.npp.1300873 https://www.nature.com/articles/1300873#supplementary-information

 Nafees, B., de Jonge, P. v. H., Stull, D., Pascoe, K., Price, M., Clarke, A., & Turkington, D. (2012). Reliability and validity of the Personal and Social Performance scale in patients with schizophrenia. Schizophrenia research, 140, 71-76.

Rabinowitz, J., Mehnert, A., & Eerdekens, M. (2006). To what extent do the PANSS and CGI-S overlap? Journal of clinical psychopharmacology, 26, 303-307

RSFST CFA_METHODS revised

METHODS
PARTICIPANTS
Individuals with schizophrenia were recruited at three community psychiatric rehabilitation centers and one psychiatric day care center at Taipei City Hospital in northern Taiwan from November 2014 to July 2015. Inclusion criteria were as follows: (1) diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5); (2) ages more than 18 years old; and (3) at least an elementary level of education graduating from primary school; and (4) ability to understand and provide informed consent. Exclusion criteria were as follows: (1) severe brain injuries and impaired cognitive ability and (2) with diagnoses of substance use (?). This study was approved by the Institutional Review Board of Taipei City Hospital(TCHIRB-10406117). Informed consent for participation was obtained from the participants personally.
PROCEDURE
Participants who met the inclusion criteria and signed the informed consent were assessed by the raters. The self-report R-SFST was administered in a quiet environment to groups of 6-8 participants at a time. Demographic and clinical information of the participants were collected from clinical records.


INSTRUMENT
The Revised Social Function Scale-Taiwan short version (RSFST) is developed to assess comprehensive domains of social function commonly used to measure social function in patients with schizophrenia (Song, 2001). RSFST consists of 3673 items divided into six domains: 10-item social/withdraw, 10-item sociality, 10-item communications, 13-item leisure activities, 15-item the ability of independence, and 15-item the performance of independence, and employment subscales. The RSFS assesses the frequency of interpersonal interaction with others in recently 3 months on a 4-point scale (0-3) from rare, seldom, sometimes, and often. The score range of the RSFS is 0-219. A higher score represents better social function.  It takes 20 to 30 minutes to fill out the RSFS. 


However, the disadvantages of SFST were as follows: (1) high missing rates on items in SFST, (2) two subscales (independence-competence and independence-performance subscales) having ceiling effects could not discriminate patients with high social function, (3) two subscales had low internal consistency (Chiu et al., 2012). The above results would threaten the validity and reliability of SFST and limit its utility in both clinical and research settings.
As a result, our study revised SFST into the Revised Social Functioning Scale –Taiwan short version (R-SFST). It consists of 27 items divided into six domains: 4-item social/withdraw, 5-item sociality, 5-item communications, 4-item leisure activities, 4-item ability of independence, and 5-item performance of independence.


*RSFS的發展說明，可以放在introduction。主要是參考SFS及SFST兩個版本(要一起引用)。
*由RSFS(73 item)到RSFS short form(27 item)，其domain的名稱，要一致。

DATA ANALYSIS
The statistical procedures were computed using SPSS and EQS. The factorial structure of the general linear model (GLM) was assessed through confirmatory factor analysis (CFA). CFA was conducted to evaluate the 10 6 one-factor structure. The diagonally weighted least squares method was used to estimate CFA parameters (Forero, Maydeu-Olivares, & Gallardo-Pujol, 2009; Minrdila, 2010). We examined goodness-of-fit indices to determine the unidimensional construct of items. Four Five goodness-of-fit indices were used to examine the level of fit between the overall model and data, such as the ratio of chi-square value to the degrees of freedom, comparative fit index (CFI), Tucker-Lewis index (TLI), and the root mean square error of approximation (RMSEA). The criteria of a good model fit were χ2 / df<3.0, CFI<>0.95, TLI>0.95, and RMSEA<0.08 (Bolle, 1989; Hu and Bentler, 1999; Bentler and Bonnett, 1980; Browne & Cudeck, 1993). Models with χ2/df < 3.00, CFI > .90, TLI > .90, and RMSEA < .08 are considered to have acceptable model fit (Dwinger, Kriston, Ha¨ rter, & Dirmaier, 2015).
*再補上這一段說明，我們的model是可接受的。另【<】是小於等於(一下找不到符號)。
Dwinger, S., Kriston, L., Ha¨ rter, M., & Dirmaier, J. (2015). Translation and validation of a multidimensional instrument to assess health literacy.Health Expectations, 18(6), 2776Y2786. doi:10.1111/hex.12252

After a domain presented a sufficient model fit, we estimated the factor loadings of the items to represent the correlation between the item and its corresponding factor. If the factor loading was <0.50, we deleted the item.
* We deleted the items with factor loading less than 0.5. 這需要文獻的支持。

*2nd order CFA,還沒寫。

WFOT 2018 progress 2

2018/2/13
1.操作CFA in EQS.
2.回憶AMOS.

CFA of RSFST_METHODS

CFA of the R-SFST for patients with schizophrenia living in the community

2. Method

2.1 Participants

  Individuals with schizophrenia were recruited from three community psychiatric rehabilitation centers and Psychiatric Day Care Center at Taipei City Hospital in Taiwan in November 2014 to July 2015. Inclusion criteria were as follows: (1) diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V); (2) ages more than 18 years old; (3) at least graduating from primary school; and (4) ability to understand and provide informed consent. Exclusion criteria were as follows: (1) severe brain injuries and impaired cognitive ability and (2) with diagnoses of substance use. This study was approved by the Institutional Review Board of Taipei City Hospital.

2.2 Procedures

Participants who met the inclusion criteria and signed the informed consent were assessed by the raters. The self-report R-SFST was administered in a quiet environment to groups of 6-8 participants at a time. Demographic and clinical information of the participants were collected from clinical records.

2.3 Instrument

Social Function Scale-Taiwan short version (SFST) is commonly used to measure social function in patients with schizophrenia (Song, 2001). SFST consists of 36 items divided in to seven domains: social engagement/withdraw, sociality, interpersonal, independence-competence, independence-performance, recreation, and employment subscales. However, the disadvantages of SFST were as follows: (1) high missing rates on items in SFST, (2) two subscales (independence-competence and independence-performance subscales) having ceiling effects could not discriminate patients with high social function, (3) two subscales had low internal consistency (Chiu et al., 2012). The above results would threaten the validity and reliability of SFST and limit its utility in both clinical and research settings.

  As a result, our study revised SFST into the Revised Social Functioning Scale –Taiwan short version (R-SFST). It consists of 27 items divided into six domains: 4-item interpersonal interaction, 5-item sociality, 5-item communications, 4-item leisure activities, 4-item ability of independence, and 5-item performance of independence.

2.4 Data analysis

  The statistical procedures were computed using SPSS and EQS. The factorial structure of the general linear model (GLM) was assessed through Confirmatory Factor Analysis (CFA). CFA was conducted to evaluate the 10 one-factor structure. The diagonally weighted least squares method was used to estimate CFA parameters (Forero, Maydeu-Olivares, & Gallardo-Pujol, 2009; Minrdila, 2010). We examined goodness-of-fit indices to determine the unidimensional construct of items. Four goodness-of-fit indices were used to examine the level of fit between the overall model and data, such as the ratio of chi-square value to the degrees of freedom, comparative fit index (CFI), Tucker-Lewis index (TLI), and the root mean square error of approximation (RMSEA). The criteria of a good model fit were χ2 / df<3.0, CFI>0.95, TLI>0.95, and RMSEA<0.08 (Bolle, 1989; Hu and Bentler, 1999; Bentler and Bonnett, 1980; Browne & Cudeck, 1993).

  After a domain presented a sufficient model fit, we estimated the factor loadings of the items to represent the correlation between the item and its corresponding factor. If the factor loading was <0.50, we deleted the item.

References

宋麗玉（民 90）。精神病患社會功能量表之發展與驗證-以實務應用為向。 中華心理衛生學刊，14，33-65。

Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological bulletin, 88(3), 588.

Bollen, K. A. Structural Equations With Latent Variables. 1989 New York. NY Wiley.

Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. Sage focus editions, 154, 136-162.

Chiu, E. C., Lee, Y., Lai, K. Y., Kuo, C. J., Lee, S. C., & Hsieh, C. L. (2015). Construct validity of the Chinese version of the Activities of Daily Living Rating Scale III in patients with schizophrenia. PloS one, 10(6), e0130702.

Forero, C. G., Maydeu-Olivares, A., & Gallardo-Pujol, D. (2009). Factor analysis with ordinal indicators: A Monte Carlo study comparing DWLS and ULS estimation. Structural Equation Modeling, 16(4), 625-641.

Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal, 6(1), 1-55.

Minrdila, D. (2010). Mazimyum likelihood (ML) and diagnoally weighted least squares (DWLS) estimation procedures: A comparison of estimation bias with ordinal and multivariate non-normal data. Int J Digit Soc, 1, 60-66.

煩請主任及芳瑜協助editting~謝謝!!

WFOT 2018 progress 1

2018/2/7
報告主題：
1. Ruff27 practice effect, 古芳瑜
2. R-SFS CFA, 王炫文

本週任務：
1.確認手上的分析資料，製成spss可用檔案。
2.Ruff27,請了解2種effect size的計算公式。
3.RSFS,請用EQS試跑R-SFS_27 item的1st & 2nd order,找出factor loading及R square.
4.請務必將資料跑過一遍，並製成表格貼上。周日(2/11)結束之前完成。
5. CFA的上課講義，請芳瑜寄給炫文；若闕如，請務必告知。
6. 試寫method。

我的任務：
同步在了解CFA中EQS與AMOS。

HPH 2018 conference

Title: Reproducibility of the Revised Social Functioning Scale–short version in community-dwelling individuals with schizophrenia

PURPOSE: Social dysfunction is a core feature in individuals with schizophrenia. Individuals with schizophrenia who have social dysfunction impede patients’ performance in self-care, interpersonal relationship, and work function. Using an appropriate outcome measure is critical to monitor changes in social functioning. The Revised Social Functioning Scale–short version (R-SFS) is developed to assess comprehensive domains of social function. However, the reproducibility of the R-SFS remains unknown in community-dwelling individuals with schizophrenia. We aimed to examine the test-retest reliability of the R-SFS in community-dwelling individuals with schizophrenia.

METHOD: We collected data from 119 community-dwelling individuals with schizophrenia. Each patient was assessed twice, 2-week apart. The R-SFS consists of 27 items divided into 6 domains: 4-item interpersonal interaction, 5-item sociality, 5-item communications, 4-item leisure activities, 4-item ability of independence and 5-item performance of independence. Test-retest reliability was examined using intraclass correlation coefficient (ICC). An ICC value greater than 0.80 was considered to indicate excellent test-retest agreement; 0.60 to 0.79, good agreement; 0.40 to 0.59, moderate; and less than 0.40, poor.

RESULTS: For the overall social functioning, ICC value for total scores of R-SFS was 0.88 (0.83 – 0.91 at 95% confident interval). For the 6 domains of the R-SFS, ICC values for interpersonal interaction, sociality, communication, leisure activities, the ability of independence and performance of independence were 0.81, 0.77, 0.81, 0.76, 0.60 and 0.79, respectively.

CONCLUSIONS: The total scores and 6 domains of the R-SFS had excellent to good test-retest reliability in the community-dwelling individuals with schizophrenia. The good reproducibility of the R-SFS, except ability of independence, is sufficient for use in research contexts, providing useful information for the comparison of different respondents.

沒寫到reliability為什麼在臨床施測上是重要的。20180204

剛好看到一篇文章：

Test-retest: Agreement or reliability?

我覺得有趣。字面上，
reliability是不同時間的相關。
agreement是兩次的絕對一致性。
摘要提到：單純以pearson's r探討reliability,可能會出現不法得知差異是來自：受測者的實際變化，或是測量工具的誤差；進而造成結果的錯誤解釋。
所以，more focus should be given on the real interpretation of linear correlation是有必要的；因此BA plots就加入了。

AOTA comments

2018 AOTA Annual Conference & Expo
April 19 – 22, 2018

Pre-Conference Institutes March 29

Salt Lake City, UT

Please print this page for future reference.

Submitter: Kuan-Yu  Lai 

Proposal Score Information: 

Control No.:  3520

Abstract Title: Reproducibility of the Revised Social Functioning Scale–short version in community-dwelling patients with schizophrenia

Avg Score: 31.667

Reviewer Comments (if provided by reviewers):

(Slot#AE):Learning objective less strong. Need more info about tool, especially format for administration. Need to clarify why tool is needed (what is unmet need). (Slot#BE):It would be helpful to have a sentence/statement about why it is important to measure this construct in the introduction to justify the study. It is unclear how you statistically evaluated the MDC. Was there an intervention provided or a reason that there would be change? This is unclear in the proposal. I think there is an important need for tools measuring these constructs, and it is important work. The references are a little old, but one is an essential reference for psychometric research. (Slot#P):No impact statement and very little significance of the study presented throughout the proposal.

Thank you for sharing your conference proposal with AOTA. We appreciate your participation and hope that you will submit a proposal for future conferences. A successful, relevant, and meaningful Annual Conference is dependent on professionals like yourself, committed to sharing knowledge with their peers….we applaud you and appreciate your efforts. We hope you will join us at the 2018 Annual Conference & Expo in Salt Lake City, UT. Complete program information will be available on the AOTA website in mid-December.

If you have questions, please send an email to Dianna at  conference@aota.org.

_{Control Number: 3520}

The American Occupational Therapy Association, Inc.

4720 Montgomery LanePO Box 31220Bethesda, MD 20824-1220

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HPH

AOTA 2018 conference

RSFST MDC沒上，改投HPH 2018 conference

初步修改想法：(1)依據AOTA的建議修改；(2)寫到ICC就好，MDC就省略。

We are very pleased to inform you that HPH Newsletter #89 is now online at: http://www.hph-hc.cc/hph-newsletter/english.html. Enjoy your read!

Also, please be informed that the deadline for abstract submissions for the 26^th International HPH Conference, June 6-8, 2018, Bologna, with the title:

“Health promotion strategies to achieve reorientation of health services: evidence-based policies and practices”

has been prolongued until February 4, 2018!

To submit your abstract, please go to https://www.hphconferences.org/bologna2018 and log into the system via the Login in the upper right corner. You can use the username and password you have created for one of the previous conferences. If you do not have a username you can create a new profile via clicking “Create new login”.

When logged in, click on “Abstract submission” and then on abstracts. Should you have already submitted abstracts earlier, you will find a list of all accepted abstracts here. Scroll to the bottom and click on “Create new abstract” to open the abstract submission form.

Submitters will be informed about the acceptance of their abstracts until March 30, 2018.

We are looking forward to receiving your contribution! Please do not hesitate to contact us at congress-secretariat@hphconferences.org.