2017-18 HSC Section 4 Green Book

TABLE III. Degree to Which Items in Each Scale or Subscale Measure the Same Concept.*

TABLE I. Demographics of the 40 Patients Enrolled in the Study.

Age average (range)

29.1 (15–56)

Scale

Cronbach’s Alpha

Age at first

Average (range)

17.1 (1–55)

Medical motivation

0.66

keloid (years)

Physical symptom

0.86 0.77

Ethnicity

African

13 (32.5%)

Self-esteem

Asian

3 (7.5%)

Social functioning

0.70

Black

17 (42.5%)

Total scale

0.87

Caucasian

3 (7.5%)

*The higher the Cronbach’s alpha, the greater the internal consis- tency of the questions being asked, with 0.9 showing excellent consis- tency and 0.7 A 0.9 showing good consistency.

Hispanic

6 (15%)

Native American

0 (0%)

Other

1 (2.5%)

Other keloids

None

27 (37.5%)

ment of keloids. A lack of literature on head- and neck- specific keloids and their effect on QOL limited the util- ity of basing content on literature review. Construct validity concerns whether the relation- ship between measures agree with predicted relation- ships based on theory. Two aspects of construct validity demonstrated in this study are convergent validity, in which a theorized underlying relationship corresponds with scale results, and divergent validity, in which a the- orized underlying absence of a relationship corresponds with scale data. 8 Of the subscales, the PSS (0.77) had the strongest correlation with the overall scale, and the MMS (0.57) had the weakest. This is consistent with the notion that physical symptoms are the greatest contributor to QOL with keloids, further corroborated by the high percentage of patients reporting change in size or pain as their reason for presenting. It was also expected that MMS would have the weakest correlation with the overall scale, given the differences in the underlying concepts of quality of life and motivation to seek therapy . The changes in the correlations between visit 1 and 2 results and between visit 2 and 3 results also give insight into the underlying concepts of the scale. Because the scale places an emphasis on physical symp- toms as a contributor to QOL, it followed that correla- tions between scale scores in visits 2 and 3 would be worse than between those in visits 1 and 2, given the effects of steroids on physical symptoms. On the other hand, the steroid treatments would not be expected to immediately affect self-esteem, social functioning, or medical motivation. As expected, these subscales showed

Arms

4 (10%)

Chest

7 (17.5%)

Back

4 (10%)

Abdomen

0 (0%)

Legs

1 (2.5%)

Etiology

Piercings

25 (62.5%)

Burn

0 (0%)

Surgical scar

7 (17.5%)

Bite

0 (0%)

Cut

3 (7.5%)

Acne

2 (5%)

Infection

1 (2.5%)

Unknown

5 (12.5%)

Previous treatment

Surgery

18 (45%) 26 (65%)

Steroid injection

Laser

2 (5%)

Radiation

3 (7.5%)

Reason for

Pain

19 (47.5%)

seeking medical care

Growth

24 (60%)

Change in appearance

16 (40%)

Family urging

2 (5%)

Problems with social life

10 (25%)

Problems with work/school

4 (10%)

Other

12 (30%)

study that content and construct validity were assessed. As mentioned previously, content for questions was derived from expert opinion regarding the most common complaints and concerns of patient’s presenting for treat-

TABLE II. Test-Retest Pearson R Between Visits for Each Subscale as Well as the Scale as a Whole.

TABLE IV. Comparing Subscales to the Whole.*

Scale

Pearson Correlation

Test-Retest Pearson R (Visits 1–2)

Test-Retest Pearson R (Visits 2–3)

Scale/Subscale

Medical Motivation Subscale (MMS)

0.57

Physical Symptoms Subscale (PSS)

0.77 0.73

Physical symptoms

0.65

0.19

Self Esteem Subscale (SES)

Self-esteem

0.68 0.83

0.81 0.52

Social Functioning Subscale (SFS)

0.72

Social functioning

Medical motivation

0.65

0.55

Correlations between each subscale and the overall scale demon- strate how reliably each scale measures the same underlying concept. The more directly related the variables, the closer to 1.0 the correlation.

Total scale

0.70

0.77

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