Evaluating a Non-verbal Assessment Tool in Nursing Students and Staff at the University of Botswana
Evaluating well-being in non-Western populations has been hampered by the fact that most psychometric instruments are not culturally sensitive. One possible way to remove cultural biases is by eliminating the verbal content from the assessment. The Well-Being Picture Scale (WPS) is a ten item conceptual assessment that has been used to evaluate well-being in a variety of populations. The purpose of this study was to examine its utility in a sample of nursing students and staff from the University of Botswana in Gaborone, Botswana. The WPS and a traditional English language based depression scale, the Zung Self-rated Depression Scale (SDS) were distributed to students and staff at the school of nursing; 71 (31 male, 40 female (mean age= 28.2 years) returned the questionnaires. Reliability of the scales was assessed using Cronbach’s alpha. Validity of the WPS was evaluated by examining its sensitivity and specificity using the SDS as a referent, with previously published cut-points denoting either well-being or depression from the scales. The results show that the WPS has good reliability (α=0.863) and that when compared to the SDS depression scale, has excellent specificity in identifying positive well-being, but poor sensitivity in detecting depression. The poor sensitivity could be the result of the WPS being a state indicator, while the SDS is a trait measure, or that sociocultural and linguistic factors are affecting the scale comparisons. Nonetheless, the results suggest that the WPS may be useful as way to measure an emotional state of well-being that is independent of cultural context.
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