OBJECTIVE: To evaluate the construct validity of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. SUBJECTS: A total of 4377 middle-aged, obese subjects in the Swedish Obese Subjects (SOS) study. METHODS: The total sample was randomly split into two data subsets and psychometric testing was performed separately in each sample. Multitraitamulti-item analysis was conducted to test scaling assumptions and factor analysis was used to test the factor structure. Measures of mental well-being (MACL, HAD) were used for testing criterion-based validity. RESULTS: The Cognitive Restraint factor was consistently reproduced and scaling analysis demonstrated strong itemscale discriminant validity, while the item-scale convergent validity was unsatisfactory. The internal structure of the Disinhibition scale was weak. Most Disinhibition and Hunger items grouped in one global factor labeled Uncontrolled Eating. A third cluster containing items on Emotional Eating was also identi®ed. The obtained three-factor structure was cross-validated and replicated across subgroups by gender, age and BMI. CONCLUSION: The original TFEQ factor structure was not replicated. A short, revised 18-item instrument was constructed, representing the derived factors of Cognitive Restraint, Uncontrolled Eating and Emotional Eating. The most ef®cient items were used to boost both the convergent and discriminant validity of the scales.

Health-related quality of life in COPD: why both disease-specific and generic measures should be used. C.P. Engström, L.O. Persson, S. Larsson, M. Sullivan. #ERS Journals Ltd 2001. ABSTRACT: Although research has consistently demonstrated that chronic obstructive pulmonary disease (COPD) impairs health-related quality of life (HRQL), little agreement has been evidenced regarding the factors identified as contributing to impaired HRQL. The aim was to study such factors using well established generic and specific HRQL instruments.The patients (n~68) were stratified by forced expiratory volume in one second (FEV1) to represent a wide range of disease severity. Pulmonary function, blood gases and 6-min walking distance test (6MWD) were assessed. HRQL instruments included: St George9s Respiratory Questionnaire (SGRQ), Sickness Impact Profile (SIP), Hospital Anxiety and Depression Scale and Mood Adjective Check List.The strength of the impact of COPD on HRQL was represented along a continuum ranging from lung function, functional status (physical and psychosocial) to wellbeing. Although correlations between FEV1 versus SGRQ total and SIP overall scores (r~-0.42 and -0.32) were stronger than previously reported, multiple regression analyses showed that lung function contributed little to the variance when dyspnoearelated limitation, depression scores and 6MWD were included in the models. These three factors were important to varying degrees along the whole range of HRQL.Physiological, functional and psychosocial consequences of chronic obstructive pulmonary disease are only poorly to moderately related to each other. The present study concludes that a comprehensive assessment of the effects of chronic obstructive pulmonary disease requires a battery of instruments that not only tap the diseasespecific effects, but also the overall burden of the disease on everyday functioning and emotional wellbeing.

Due to unfortunate choices of response scale and psychometric model earlier analyses of mood adjective check lists have given a confused and complex picture of the area. When an adequate response scale was applied and a simplex rather than a common factor analysis model was utilized it was found, in two empirical studies, that mood was possible to describe with a few bipolar factors. A theory is suggested where mood is seen as basically two‐dimensional: one dimension being activity and the other pleasantness. More or less specific definitions of the content of experience with reference to the situation may then be used to define further dimensions, such as social orientation.

Moving into a residential care facility requires a great deal of adjustment to an environment and lifestyle entirely different from that of one's previous life. Attachment to place is believed to help create a sense of home and maintain self-identity, supporting successful adjustment to contingencies of ageing. The purpose of this study was to deepen our understanding of processes and strategies by which older people create a sense of home in residential care. Our findings show that a sense of home in residential care involves strategies related to three dimensions of the environment - attachment to place, to space and attachment beyond the institution - and that the circumstances under which older people manage or fail in creating attachment, consist of psychosocial processes involving both individual and shared attitudes and beliefs. Assuming that attachment is important to human existence regardless of age, attention must be paid to optimize the circumstances under which attachment is created in residential care, and how nursing interventions can help speed up this process due to the frail and vulnerable state of most older residents.

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