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20832

Title

Instrument evaluation: A study of the reliability, validity, and responsiveness of a self-administered instrument to measure global well-being

URL

Journal

Palmer Jnl Res. 1995 Mar;2(1):15-22

Author(s)

Subject(s)

Peer Review

Yes

Publication Type

Article

Abstract/Notes

In order to substantiate the effects of chiropractic care, appropriate outcome measures must be available. Patient-centered instruments are gaining credibility for demonstrating these effecrs on general health status and well-being. Although a number of questionnaires are in use, there appears to be a need for an instument measuring an immediate sense of general well-being, that can be administered quickly and scored easily. The purpose of this study is to develop such an instrument and to test it for reliability, validity, and responsiveness to clinical changes. The instrument, the Global Well-Being Scale (GWBS), is a version of a Visual Analog Scale (VAS). Intraclass correlation coefficient was used to assess reliability. To assess construct validity, the GWBS was compared to the RAND-36 Health Status Survey and to a VAS for pain, using the Pearson product moment correlation. Responsiveness to clinical change was assessed in twenty-six symptomatic patients by its administration before and immediately after a chiropractic adjustment. The intraclass correlation coefficient was 0.93. The GWBS was significantly correlated to the emotional well-being and energy subscales of the RAND-36 in a non-patient population, but no statistically significant correlations were observed in the group of twenty-six patients. The GWBS was not significantly correlated with the VAS for pain. The effect size of the pre- to post-change (0.91) was considered large. The results of this initial study indicate that the instrument may be useful to clinicians as a supplement to other measures, particularly in assessing post-adjustment response to treatment in terms of general state of well-being. Further study is needed to better characterize the quality or qualities this instrument measures. Combined with other measures, it may have utility in monitoring treatment plans and in assessing possible placebo effects.

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