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Evaluating the reliability of multi-item scales: a non-parametric approach to the ordered categorical structure of data collected with the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale.

Journal article
Authors Lina Bunketorp
Jane Carlsson
Jan Kowalski
Elisabet Stener-Victorin
Published in Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine
Volume 37
Issue 5
Pages 330-4
ISSN 1650-1977
Publication year 2005
Published at Institute of Occupational Therapy and Physiotherapy
Pages 330-4
Language en
Keywords Fear, physiology, Follow-Up Studies, Humans, Kinesthesis, physiology, Movement, physiology, Neuropsychological Tests, Phobic Disorders, diagnosis, physiopathology, Questionnaires, Reproducibility of Results, Self Efficacy, Sweden, Whiplash Injuries, diagnosis, physiopathology, psychology
Subject categories Orthopaedics


OBJECTIVE: To compare the ability of a rank-invariant non-parametric method with that of kappa statistics to evaluate the reliability of the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale by identifying systematic and random disagreement. The aim was, further, to compare 2 different statistical approaches to obtain a global value from multi-item scales. DESIGN: A test-retest study. SUBJECTS: A total of 46 patients with whiplash-associated disorders were enrolled and 39 (85%) completed the test-retest assessment. METHODS: Data from the multi-item scales were summarized using both sum and median scores. Paired data were evaluated with a rank-invariant statistical method to identify systematic and random disagreement. Data were also evaluated with kappa statistics. RESULTS: The non-parametric approach demonstrated that the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale are reliable for patients with whiplash-associated disorders. In contrast to the rank-invariant method, kappa statistics provided no information on disagreement between the 2 test occasions. Median scoring improved reliability due to lack of disagreement while the sum scores method was characterized by random individual disagreement. CONCLUSION: This study has increased understanding of the advantages and limitations of 2 non-parametric statistical methods and, it is hoped, will contribute to the development of reliable measurements.

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