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Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
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Development and initial validation of the Respirator Comfort, Wearing Experience, and Function Instrument [R-COMFI]
Sherri L LaVela1,2, Carol Kostovich1,3, Sara Locatelli1
1a Department of Veterans Affairs , VA Health Services Research and Development , Hines , Illinois.
Journal of Occupational and Environmental Hygiene
|September 17, 2016
Summary
A new 21-item instrument, the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI), was developed to measure the comfort and tolerability of filtering face-piece respirators (FFRs) in healthcare personnel. This tool aims to improve FFR adherence by identifying more comfortable options.
Area of Science:
- Occupational Health
- Medical Device Evaluation
- Psychometrics
Background:
- Filtering face-piece respirators (FFRs) are crucial for protecting healthcare personnel from airborne particles.
- Low adherence to FFRs is often linked to discomfort and intolerance.
- There is a need for a reliable instrument to assess FFR comfort and tolerability.
Purpose of the Study:
- To develop and psychometrically evaluate an instrument measuring the comfort and tolerability of FFRs.
- To create a tool that can identify FFRs with better adherence in clinical settings.
Main Methods:
- Instrument items were developed through literature reviews, focus groups, and expert refinement.
- Psychometric evaluation utilized Rasch partial credit model (PCM) analysis.
- The instrument was administered to 165 healthcare personnel across three VA facilities.
Main Results:
- Seven items were removed due to violations of independence, mis-fitting, or irrelevance.
- Category function analysis confirmed monotonic progression.
- Principal components analysis identified three subscales: Discomfort, General Wearing Experience, and Function.
- The final 21-item instrument, R-COMFI, demonstrated moderate to high person reliability and high item reliability.
Conclusions:
- The R-COMFI is a psychometrically sound measure for assessing FFR comfort and tolerability in healthcare personnel.
- This instrument can aid in identifying FFRs likely to achieve better adherence.
- The R-COMFI has potential applications within and beyond the VA healthcare system for evaluating respirator prototypes and existing devices.
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