While the majority of school-aged children associate immunizations with low levels of anxiety, fear, and pain, there is a small subset for whom needles are highly distressing (Humphrey, et al., 1992). Poorly managed, these individuals may come to avoid medical treatment (Ollendick, King, & Muris, 2002). Using Lazarus and Folkmans (1984) transactional theory of coping and Reid and colleagues (1998) development and validation of the Pain Coping Questionnaire as frameworks, the present program of research elaborated on existing knowledge about how children cope with needles. As part of Studies 1 (N = 176) and 2 (N = 302), a Coping with Needles Questionnaire (CNQ) was developed and validated; both two- and three-subscale versions of the questionnaire were examined. The resulting CNQ was composed of and scored as two separate subscales: problem-focused and emotion-focused coping. Construct validity testing demonstrated that emotion-focused coping was robustly associated with more negative experience with needles (i.e., higher anxiety, fear, pain, and lower self-efficacy). There was no main effect of problem-focused coping but it tended to moderate the negative effect of emotion-focused coping when the two interacted. Study 3 (N = 78) was designed to investigate (1) the percentage of participants who are high on only one type of coping (i.e., dominant copers) and (2) how coping responses change over time in response to repeated presentations of the same stressor. Presently there are gaps in the existing literature regarding these two targeted areas of investigation. Results of this investigation indicated that most children engage in high amounts of both problem- and emotion-focused coping when initially queried about their experience with an immunization, with approximately 30% showing a pattern of coping dominance. When participants were followed and queried about a second experience with immunization, it was found that most of them engaged in low amounts of both types of coping. This pattern of change in the distribution of coping over time was not consistent with learning effects. In other words, participants did not seem to improve their coping with experience. However, lack of a clearly positive type of coping and a six-month time-lag may have inhibited the potential for learning to occur. The utility of the CNQ for screening purposes and implications of these findings for interventions are discussed.

While the majority of school-aged children associate immunizations with low levels of anxiety, fear, and pain, there is a small subset for whom needles are highly distressing (Humphrey, et al., 1992). Poorly managed, these individuals may come to avoid medical treatment (Ollendick, King, & Muris, 2002). Using Lazarus and Folkmans (1984) transactional theory of coping and Reid and colleagues (1998) development and validation of the Pain Coping Questionnaire as frameworks, the present program of research elaborated on existing knowledge about how children cope with needles. As part of Studies 1 (N = 176) and 2 (N = 302), a Coping with Needles Questionnaire (CNQ) was developed and validated; both two- and three-subscale versions of the questionnaire were examined. The resulting CNQ was composed of and scored as two separate subscales: problem-focused and emotion-focused coping. Construct validity testing demonstrated that emotion-focused coping was robustly associated with more negative experience with needles (i.e., higher anxiety, fear, pain, and lower self-efficacy). There was no main effect of problem-focused coping but it tended to moderate the negative effect of emotion-focused coping when the two interacted. Study 3 (N = 78) was designed to investigate (1) the percentage of participants who are high on only one type of coping (i.e., dominant copers) and (2) how coping responses change over time in response to repeated presentations of the same stressor. Presently there are gaps in the existing literature regarding these two targeted areas of investigation. Results of this investigation indicated that most children engage in high amounts of both problem- and emotion-focused coping when initially queried about their experience with an immunization, with approximately 30% showing a pattern of coping dominance. When participants were followed and queried about a second experience with immunization, it was found that most of them engaged in low amounts of both types of coping. This pattern of change in the distribution of coping over time was not consistent with learning effects. In other words, participants did not seem to improve their coping with experience. However, lack of a clearly positive type of coping and a six-month time-lag may have inhibited the potential for learning to occur. The utility of the CNQ for screening purposes and implications of these findings for interventions are discussed.

The purposes of the present research were two-fold. The first purpose was the development of a test construction strategy by which an objective assessment device, based upon the unique goals of moral education within a specific school district, may be developed. The second purpose was the actual development of a psychometrically sound instrument based upon such goals. To accomplish these aims, seven interrelated studies were conducted involving a total of 775 subjects. The rationale for the nature of the test was based upon the assumptions of the direct approach to moral education. These assumptions are that children should learn and exemplify in their behavior certain values that are viewed by the community as essential to adequate socialization. Such values have been indentified by educators of the Salt Lake City School District. Therefore, the goal of measurement was the development of a test that would discriminate students who exemplify these values in their behavior from. those students who do not. The instrument was developed for the assessment of groups to aid curriculum evaluation in moral education. Disclaimers are made regarding the assessment of individuals using the instrument. The reported studies concerning the development of the test include: (1) the intial writing and field testing of the hypothetical dilemmas and alternative solutions used in the test, (2) the revision of the test based upon the field testing, (3) the item analysis and validation procedures, (4) the cross-validation of selected items, (5) an analysis of the content validity of the dilemmas that compose the test, (6) the establishment of the reliability of the test, and (7) an assessment of the effects of socially desirable response sets on test scores. In addition, normative data regarding test scores for each grade tested and a parent group were presented. The instrument developed through these procedures is an objective group test, applicable to grades 5 through 12. A content validity study provided reasonable evidence that the dilemmas that compose the test are logically related to the value goals proposed by district personnel. Studies of the reliability of the test revealed reliability coefficients from .82 (stability) to .92 (internal consistency). The concurrent validity of the test was established by selecting items that discriminated between groups of students who were identified as either exemplary of the district values or non-exemplary of the district values. These items were then successfully cross - validated on an independent sample of similar criterion groups. In addition, two studies related to the effects of socially desirable response sets on test scores were conducted. The limitations of the present research are discussed and suggestions for further research regarding the instrument are made.

Ability tests play an important role in the assessment programs of many schools. However, the inferences about ability made from such tests presume that students understand the tasks they are attempting. Task familiarity can vary by student as well as by format. By design, nonverbal reasoning tests use formats that are intended to be novel. The popularity of nonverbal reasoning tests has increased substantially in recent years because of the increasing number of English-language learner (ELL) students in many U.S. school districts. Nonverbal tests are thought to eliminate the need for language in test items and to reduce cultural content. Formats on these tests are also assumed to be equally novel for all students. However, in at least one large study, researchers found substantial differences between the average performance of ELL and non-ELL Hispanic students on three of the most widely used nonverbal tests. Although these differences might reflect real variation in cognitive development, they may also reflect differences in knowledge of test formats and the testing practices used in U.S. schools. In this study, I hypothesized that the score gaps between ELL and non-ELL students might, in part, be due to differences in test familiarity and that providing directions that include more practice and feedback might attenuate these differences. I drew from the research on universal design, dynamic assessment, and cross-cultural testing to develop three different types of directions with practice items. I then compared the effects of these three types of test directions on students completing a nonverbal figure analogies test. Figure analogies tests are generally among the best measures of reasoning abilities and are known to be quite difficult for young students. All directions were provided using video with English and Spanish audio and minor animations to concretize the instructions. The three types of directions were nonverbal-dynamic directions, verbal-dynamic directions, and a control condition that used standard test directions. The nonverbal-dynamic directions presented four practice problems that sampled the range of items on the test. Oral instructions and feedback were minimal. The verbal-dynamic directions presented the same four practice problems with more in-depth description and feedback. These directions also described useful strategies for solving items. The standard test directions presented two sample problems with minimal instruction and feedback. The sample consisted of 882 students in 40 first- and second-grade classrooms in 8 schools. A hierarchical linear model was used to control for similarity among students nested in classrooms and schools and to account for the assignment of treatment (type of directions) at the classroom level. The model included tests for main effects and interactions among treatment, ELL status, and grade. Results indicated that providing additional practice (the nonverbal-dynamic directions) led to small gains in performance, but that the more extensive set of directions (verbal-dynamic directions) were effective only for high-ability students. Contrary to the hypotheses, there was no interaction of ELL status with treatment. An unexpected finding was that use of teacher-read directions instead of video-based directions led to better performance for second-grade students. I conclude that test directions are an important means for improving test familiarity in young students, but that excessive standardization and lengthening of the directions may hinder performance. I also conclude that the choice of practice items and feedback are crucial considerations in the design of test directions.

The overall aim of this thesis was to develop and validate a self-report instrument for perceived driver competence. The thesis includes six papers and a summary. All papers focus on perceived driver competence from a measurement perspective; that is, how to develop an instrument for perceived driver competence and how to use and interpret the scores from the instrument in a reliable and valid manner. Study I reviews how perceived driver competence has been measured in other studies and discusses these methods from a measurement perspective. Most studies have examined perceived driver competence by asking drivers to compare their own skill to that of the average driver. That method is problematic, since it is not possible to determine if drivers are overconfident or not, when empirical information of their own skills is missing. In order to examine if drivers overestimate their skills or not, perceived driver competence should be compared with actual driving performance. Study II reports on the development and psychometric evaluation of a self-report instrument for perceived driver competence - the Self-Efficacy Scale for Driver Competence (SSDC). The findings provides support for construct validity, as the SSDC demonstrated sound psychometric properties and as the internal structure of the SSDC corresponded to the theoretical model used as a basis for instrument development. In study III, the psychometric properties of the SSDC were further examined using an item response theory (IRT) model. The findings confirmed the results indicated by the classical analyses in Study II. Additional information was provided by the IRT analyses, as it was indicated that the scale would benefit from fewer scale points or by putting labels on each scale point. In study IV, Swedish and Finnish candidates’ self-assessment accuracy was examined by comparing candidates’ scores on the SSDC and a similar instrument for self-assessment of driving skill used in Finland, with driving test performance. Unlike previous studies, in which drivers compared their perceived skills to that of the average driver, a relatively large proportion made a realistic assessment of their own skills. In addition, in contrast to previous studies, no gender differences were found. These results were also confirmed in study V, where the results from the Finnish instrument for self-assessment of driving skill were compared with the results from a similar instrument used in the Netherlands. Study VI further examined the construct validity of a revised version of the SSDC, combining qualitative and quantitative sources of evidence. There was a strong relationship between the SSDC and an instrument for self-assessment of driving skills, providing support for convergent validity. No relationship was found between the SSDC and driving test performance. Explanations of the lack of relationship were provided from semi-structured interviews, as they indicated that confidence in performing different tasks in the test are different from being confident of passing the test, and that the candidates are familiar neither with assessing their own skills nor with the requirements for passing the test. In conclusion, the results from this thesis indicated that the choice of methods for assessing perceived driver competence as well as the quality of these methods affect the validity. The results provided support for different aspects of construct validity of the SSDC. Moreover, the findings illustrated the benefits of combining different methods in test validation, as each method contributed information about the validity of the SSDC. The studies in this thesis mainly examined internal and external aspects of construct validity. Future studies should examine procedural validity of the SSDC.

This master paper tries to analyse the structure of reading as a complicated multiple process, to reveal its components, to study the aspects of reading evaluation, text formation, the levels of reading comprehension, etc. Reading is one of the most important abilities the man has. At first sight it may seem as a simple and matter-of-course ability, but after studying it thoroughly it becomes clear that it is not true. Not only mechanical decoding of signs (reading), but also reading comprehension is significant to the growing, developing and mature enough personality. The problem of reading comprehension evaluation has been holding the interest of not only foreign, but also Lithuanian educators and researchers who go deep into this problem, try to carry out various investigations for the last decades. There is not much methodological literature about this topic but all the investigations that have been carried out to date are rather important and informative. United standardized test of reading comprehension has not been prepared yet, so teachers of the Lithuanian language try to create them themselves or to adapt tests prepared by others. The preparation of the valid test itself is a very complicated and responsible process that requires many efforts. Certain requirements are brought, so there were attempts to study the principles of the test formation during this research as in detail as possible, to check the reliability of the test in the different stages of its... [to full text]

Impairments in attention are commonly seen in individuals with traumatic brain injury (TBI). While attention assessment measurements have been developed rigorously and utilized frequently in cognitive neurorehabilitation, there is a paucity of auditory attention assessment instruments that are ecologically valid and that assess different subtypes of attention. Yet, deficits in auditory attention can severely limit everyday functioning, negatively impact work and personal relationships and compromise personal safety. The purpose of this study was to develop and to investigate the psychometric properties of a Music-based Attention Assessment (MAA) instrument. The MAA is a multiple choice, melodic contour identification test, designed to assess three different types of auditory attention, including sustained attention, selective attention, and divided attention. The MAA was piloted with patients with TBI (n = 15) and healthy adults (n = 30) separately to evaluate preliminary psychometric properties. Both pilot studies reported that the MAA possessed a very high reliability and appropriate item properties. However, the MAA was revised due to a ceiling effect on mean test scores in the healthy adult group. The revised version of the MAA was administered to healthy adults (n = 165) as well as TBI patients (n= 22) to investigate construct validity, item properties, test reliability, and difference in MAA performance between groups. Here, psychometric validation of the revised version of the MAA is described, and the obtained results reported. Exploratory factor analysis identified five-factor constructs, supporting the different types of attention that underlie the test items of the revised version of the MAA. The factors identified were Sustained-Short, Sustained-Med to Long, Selective-Noise, Selective & Divided, and Divided-Long. After item elimination, the finalized 45-item MAA in relation to the identified five-factor constructs provided evidence of high internal consistencies as computed by split-half reliability coefficients (r = .836) and Cronbach’s alpha (α = .940), indicating homogeneity of test items within each of the five subtest as well as for the total test. As predicted, significant differences were found between the healthy adult and TBI patient samples across the exploratively obtained five-factor constructs of the revised version of the MAA. The MAA performance was significantly better in the healthy adult group than in the TBI patient group, except on the Sustained Attention–Short Subtest, indicating pervasive attention impairments in patients with TBI. The finding also suggests that a basic level of sustained attention to deal with a small amount of auditory information during a limited time might be intact for the patients with TBI who have a moderate to severe level of brain injury. The aggregate findings suggest that the MAA is a valid and reliable measure that provides diagnostic information in regards to the three types of auditory attention deficits frequently observed in patients with TBI. The use of melodic contours in attention assessment is discussed along with limitations of the study and suggestions for future research. The MAA, when used in conjunction with attention assessment instruments in different sensory modalities, would provide a greater level of precision in the attention assessment of patients with TBI, resulting in more symptom specific and individualized rehabilitation and treatment.

The aim of this study is to examine the complexity of teachers’ assessment practice. It is divided into a two part-studies. The first part aims to determine what type of knowledge is tested in teachers’ written tests, and how they relate to the curriculum. To answer this we analyzed two tests from four different teachers. The second part aims to find out how different factors influence the teacher’s in his or hers test construction. To answer this we interviewed the four teachers who provided the test. Together, the two parts helps us to understand how tests work, as well as why they are constructed the way they are. The study uses two different theories as analytical tools. The first part of the study uses Bloom’s revised taxonomy to determine different types of knowledge. The theory is also used to determine the knowledge of the curriculum. The second theory, which relates to the second part of the study, is a frame factor theory, to define different internal and external factors that influence in a teacher’s work. Methods used in the study are text analysis for the teachers’ tests and the curriculum, and interviews for the frame factors. The results of the first part shows a discrepancy between the knowledge tested in the tests and the knowledge expressed in the curriculum. Most notable was the lack of questions requiring evaluating skills in the tests, while the curriculum mentions it 4 times out of 9 different requirements. The results of the second part showed that a number of factors influence teachers in their test construction. The main factor influencing teachers in the test construction, mentioned by all teachers, were lack of ‘social moderation’, i.e. working within assessment as a group and being able to discuss and reflect with colleagues. Other factors mentioned were time and organization, which were partly mentioned along with the responsibility or involvement of the head teacher.

A acurácia de uma variável consiste na capacidade de a mesma representar realmente o que ela deveria representar. A definição conceitual de acurácia diagnóstica é baseada no pressuposto de que há uma ampla variedade de diagnósticos possíveis nas situações clínicas além dos diagnósticos que são altamente acurados. O objetivo desta pesquisa foi desenvolver um instrumento para estimar a acurácia de diagnósticos de enfermagem a partir de dados escritos da avaliação de paciente. Tratou-se de estudo quantitativo de desenvolvimento metodológico, realizado em 3 fases: teórica, empírica e analítica. Na fase teórica elaborou-se a definição de acurácia do diagnóstico de enfermagem e os itens do instrumento, submetendo-os a validação de conteúdo e teste piloto; na fase empírica, o instrumento definido na etapa anterior foi aplicado por enfermeiros especialistas em diagnóstico de enfermagem com a finalidade de estimar a validade e a confiabilidade do instrumento na fase analítica. O instrumento elaborado foi denominado de Escala de Acurácia de Diagnóstico de Enfermagem – EADE, e foi estruturado com base no conceito de que a acurácia de um diagnóstico de enfermagem é o julgamento de um avaliador quanto ao grau de relevância, especificidade e coerência das pistas existentes para o diagnóstico. O instrumento ficou composto por 4 itens: Presença de pistas (manifestações dos pacientes que representam indícios, vestígios, sinais, indicações ou características de um diagnóstico de enfermagem - item graduado em “sim"ou “não"); Relevância da pista (propriedade de uma pista de ser importante como indicador de um diagnóstico de enfermagem - item graduado em “alta/moderada" ou “baixa"); Especificidade da pista (propriedade de uma pista de ser própria e distintiva de um diagnóstico de enfermagem - item graduado em “alta/moderada" ou “baixa/nula"); Coerência da pista (propriedade de uma pista de ser consistente com o conjunto das informações disponíveis - item graduado em “alta/moderada" ou “baixa/nula"). Como indicativo de validade da EADE, os dados estatísticos mostram que os 4 itens do instrumento foram importantes para predizer diagnósticos de enfermagem acurados: Pista (OR 1,95 /IC 95% [1,78 ? 2,14], p = 0,000); Relevância (OR 1,73 /IC 95% [1,52 ? 1,98], p = 0,000); Especificidade (OR 2,41 IC 95% [2,11 ? 2,76], p = 0,000); Coerência (OR 3,92 /IC 95% [3,40 ? 4,53], p =0,000). A EADE obteve coeficiente de confiabilidade de Kuder-Richardson de 0,92 e de Hoyt de 0,92, indicando alta confiabilidade. A EADE mostrou boa sensibilidade e especificidade: área sob a curva ROC = 0,79, p = 0,000 e IC 95% [0,78?0,79]. O estudo atual permitiu desenvolver um instrumento para avaliar a acurácia de diagnósticos de enfermagem a partir de dados escritos. A EADE será refinada em estudos futuros / The accuracy of a variable consists of its capacity to actually represent what it was meant to represent. The conceptual definition of diagnosis accuracy is based on the presupposition that there is a wide variety of possible diagnosis in clinical situations, besides those diagnoses that are highly accurate. This research has set out to develop an instrument to estimate the accuracy of nursing diagnoses from the written data of patient evaluation. A quantitative study of methodological development was carried out, in 3 phases: a theoretical, an empirical and an analytical one. In the theoretical phase, the definition of accuracy of nursing diagnosis and the items of the instrument were shaped and subjected to content validation and pilot testing; in the empirical phase, the instrument defined previously was applied by nurses who are specialists in nursing diagnosis, aiming at estimating the validity and reliability of the instrument in the analytical phase. The instrument was named Escala de Acurácia de Diagnóstico de Enfermagem - EADE, and was structured according to the concept that the accuracy of a nursing diagnosis is the judgment of a rater in relation to the degree of relevance, specificity and coherence of the existing cues for the diagnosis. The instrument was made of 4 items: Presence of cues (manifestations of those patients who represent evidences, vestiges, signals, indications or characteristics of a nursing diagnosis - item graded as “yes" or “no"); Relevance of the cue (the property of a cue being important as an indicator of a nursing diagnosis - item graded as “high/moderate" or “low"); Specificity of the cue (the property of a cue being proper and distinctive of a nursing diagnosis - item graded as “high/moderate" or “low/nil"); Coherence of the cue (the property of a clue being consistent with the amount of information available - item graded as “high/moderate" or “low/nil"). As an indicator of the validity of the EADE, the statistic data showed that the 4 items of the instrument were important to predict accurate nursing diagnoses: Cue (OR 1,95 /IC 95% [1,78 ? 2,14], p = 0,000) Relevance (OR 1,73 /IC 95% [1,52 ? 1,98], p = 0,000); Specificity (OR 2,41 IC 95% [2,11 ? 2,76], p = 0,000); Coherence (OR 3,92 /IC 95% [3,40 ? 4,53], p = 0,000). The EADE had the Kuder-Richardson coefficient of reliability of 0.92 and the Hoyt coefficient of 0,92, which indicates high reliability. The EADE showed good sensitivity and specificity: area under curve ROC = 0,79, p = 0.000 and IC 95% [0,78 ? 0,79]. This study has led to the development of an instrument to assess the accuracy of nursing diagnoses from written data. The EADE shall be refined in future studies

A acurácia de uma variável consiste na capacidade de a mesma representar realmente o que ela deveria representar. A definição conceitual de acurácia diagnóstica é baseada no pressuposto de que há uma ampla variedade de diagnósticos possíveis nas situações clínicas além dos diagnósticos que são altamente acurados. O objetivo desta pesquisa foi desenvolver um instrumento para estimar a acurácia de diagnósticos de enfermagem a partir de dados escritos da avaliação de paciente. Tratou-se de estudo quantitativo de desenvolvimento metodológico, realizado em 3 fases: teórica, empírica e analítica. Na fase teórica elaborou-se a definição de acurácia do diagnóstico de enfermagem e os itens do instrumento, submetendo-os a validação de conteúdo e teste piloto; na fase empírica, o instrumento definido na etapa anterior foi aplicado por enfermeiros especialistas em diagnóstico de enfermagem com a finalidade de estimar a validade e a confiabilidade do instrumento na fase analítica. O instrumento elaborado foi denominado de Escala de Acurácia de Diagnóstico de Enfermagem – EADE, e foi estruturado com base no conceito de que a acurácia de um diagnóstico de enfermagem é o julgamento de um avaliador quanto ao grau de relevância, especificidade e coerência das pistas existentes para o diagnóstico. O instrumento ficou composto por 4 itens: Presença de pistas (manifestações dos pacientes que representam indícios, vestígios, sinais, indicações ou características de um diagnóstico de enfermagem - item graduado em “sim”ou “não”); Relevância da pista (propriedade de uma pista de ser importante como indicador de um diagnóstico de enfermagem - item graduado em “alta/moderada” ou “baixa”); Especificidade da pista (propriedade de uma pista de ser própria e distintiva de um diagnóstico de enfermagem - item graduado em “alta/moderada” ou “baixa/nula”); Coerência da pista (propriedade de uma pista de ser consistente com o conjunto das informações disponíveis - item graduado em “alta/moderada” ou “baixa/nula”). Como indicativo de validade da EADE, os dados estatísticos mostram que os 4 itens do instrumento foram importantes para predizer diagnósticos de enfermagem acurados: Pista (OR 1,95 /IC 95% [1,78 ? 2,14], p = 0,000); Relevância (OR 1,73 /IC 95% [1,52 ? 1,98], p = 0,000); Especificidade (OR 2,41 IC 95% [2,11 ? 2,76], p = 0,000); Coerência (OR 3,92 /IC 95% [3,40 ? 4,53], p =0,000). A EADE obteve coeficiente de confiabilidade de Kuder-Richardson de 0,92 e de Hoyt de 0,92, indicando alta confiabilidade. A EADE mostrou boa sensibilidade e especificidade: área sob a curva ROC = 0,79, p = 0,000 e IC 95% [0,78?0,79]. O estudo atual permitiu desenvolver um instrumento para avaliar a acurácia de diagnósticos de enfermagem a partir de dados escritos. A EADE será refinada em estudos futuros / The accuracy of a variable consists of its capacity to actually represent what it was meant to represent. The conceptual definition of diagnosis accuracy is based on the presupposition that there is a wide variety of possible diagnosis in clinical situations, besides those diagnoses that are highly accurate. This research has set out to develop an instrument to estimate the accuracy of nursing diagnoses from the written data of patient evaluation. A quantitative study of methodological development was carried out, in 3 phases: a theoretical, an empirical and an analytical one. In the theoretical phase, the definition of accuracy of nursing diagnosis and the items of the instrument were shaped and subjected to content validation and pilot testing; in the empirical phase, the instrument defined previously was applied by nurses who are specialists in nursing diagnosis, aiming at estimating the validity and reliability of the instrument in the analytical phase. The instrument was named Escala de Acurácia de Diagnóstico de Enfermagem - EADE, and was structured according to the concept that the accuracy of a nursing diagnosis is the judgment of a rater in relation to the degree of relevance, specificity and coherence of the existing cues for the diagnosis. The instrument was made of 4 items: Presence of cues (manifestations of those patients who represent evidences, vestiges, signals, indications or characteristics of a nursing diagnosis - item graded as “yes” or “no”); Relevance of the cue (the property of a cue being important as an indicator of a nursing diagnosis - item graded as “high/moderate” or “low”); Specificity of the cue (the property of a cue being proper and distinctive of a nursing diagnosis - item graded as “high/moderate” or “low/nil”); Coherence of the cue (the property of a clue being consistent with the amount of information available - item graded as “high/moderate” or “low/nil”). As an indicator of the validity of the EADE, the statistic data showed that the 4 items of the instrument were important to predict accurate nursing diagnoses: Cue (OR 1,95 /IC 95% [1,78 ? 2,14], p = 0,000) Relevance (OR 1,73 /IC 95% [1,52 ? 1,98], p = 0,000); Specificity (OR 2,41 IC 95% [2,11 ? 2,76], p = 0,000); Coherence (OR 3,92 /IC 95% [3,40 ? 4,53], p = 0,000). The EADE had the Kuder-Richardson coefficient of reliability of 0.92 and the Hoyt coefficient of 0,92, which indicates high reliability. The EADE showed good sensitivity and specificity: area under curve ROC = 0,79, p = 0.000 and IC 95% [0,78 ? 0,79]. This study has led to the development of an instrument to assess the accuracy of nursing diagnoses from written data. The EADE shall be refined in future studies