Evaluation of methods used for estimating content validity

Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students

BACKGROUND

Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career.

OBJECTIVE

To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale.

DESIGN

Cross-sectional survey.

METHODS

Pre-registration nursing students enrolled in undergraduate nursing programs across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing.

RESULTS

Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: a) identified nursing as their first career choice (p = 0.002); b) were in their final year of program enrolment (p = 0.016); and c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions.

CONCLUSION

The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students.

IMPACT STATEMENT

Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

NEUROGENIC DYSFUNCTION OF THE LOWER URINARY TRACT: CONSTRUCTION AND VALIDATION OF AN INSTRUMENT FOR NURSING CONSULTATION

Objective: To construct and validate the content of a data collection instrument for the nursing consultation of people with neurogenic lower urinary tract dysfunction in outpatient follow-up. Methods: This is a methodological study composed of two stages: elaboration of the instrument and content validation. Through the search for scientific evidence found in the literature, an instrument for admission consultation wasdeveloped. The content was validated in August 2021 by experts through independent reviews. Results: After the evaluation performed, some modifications were necessary for better adaptation and final presentation of the instrument developed. In the content analysis, 62 items with mean content validity reason below 0.78 were identified, which were excluded from the instrument. The final instrument had 160 items organized into three parts. Conclusion: The instrument represents a guide for the nursing consultation and for futureinvestigations, contributing to the improvement of the quality of care, through the systematization of care and a comprehensive approach to care for this clientele.

DISFUNÇÃO NEUROGÊNICA DO TRATO URINÁRIO INFERIOR: CONSTRUÇÃO E VALIDAÇÃO DE INSTRUMENTO PARA CONSULTA DE ENFERMAGEM

Objetivo:Construir e validar conteúdo de instrumento de coleta de dados para a consulta de enfermagem à pessoa com disfunção neurogênica do trato urinário inferior em seguimento ambulatorial. Métodos: Trata-se de um estudo metodológico composto de duas etapas: elaboração do instrumento e validação do conteúdo. Por meio da busca de evidências científicas encontradas na literatura, foi elaborado um instrumento para consulta de admissão. O conteúdo foi validado, no mês de agosto de 2021, por nove especialistas, mediante revisões independentes. Resultados: Após a avaliação realizada, algumas modificações foram necessárias para melhor adequação e apresentação final do instrumento desenvolvido. Na análise de conteúdo, foram identificados 62 itens com razão de validade de conteúdo médio abaixo de 0,78, sendo estes excluídos do instrumento, que ficou na sua versão final com 160 itens, organizados em três partes. Conclusão: O instrumento representa um norteador para a consulta de enfermagem e para futuras pesquisas, contribuindo na melhoria da qualidade da assistência, pela sistematização da assistência e por uma abordagem integral de cuidados a essa clientela.

Factors Influencing the Use of Geospatial Technology with LiDAR for Road Design: Case of Malaysia

This study seeks a better understanding of the acceptance of geospatial technology with Light Detention and Ranging (LIDAR) in road design in a developing country, Malaysia. Existing surveying measurement methods to provide quick, accurate, and reliable information are unsuccessful in producing an expected result, especially in large areas. In addition, topographic data cannot be observed well with the conventional total station method in areas under thick canopies, which is challenging to identify road areas at risk to the environment, such as slope failure. Geospatial surveying technology by LiDAR helps in measuring fields over a wide area and provides a broader spatial extent. At the same time, the laser capability of airborne LiDAR, which penetrates the canopy, helps give accurate readings on the terrain. However, the use of LiDAR geospatial technology for use in road design is still insufficient to date. Thus, this study is developed to identify the factors that influence the use of LiDAR in road design among engineers. Factors identified are barriers, motivation, and strategy. Barrier factors consist of lack of knowledge, risk, cost, and human aspects that slow down the development of LiDAR use. On the other hand, motivational factors consist of encouraging engineers to obtain knowledge about LiDAR and to use it more widely. Meanwhile, a strategy factor form increases LiDAR measurement methods through activities or work procedures. The finding shows that barriers and strategy factors are the significant factors that affect the acceptance of LiDAR among engineers. However, motivational factors have no significant effect to engineers in accepting the use of LiDAR. The advantages of this study and its limitations are also discussed. Finally, this study also provides compilation of few suggestions pertaining this topic to improve future research.

The Chinese version of the Abrams geriatric Self-neglect scale:Translation, validity, and reliability

OBJECTIVES

To translate, cross-culturally adapt, and validate the Abrams Geriatric Self-neglect Scale (AGSS) for the older population in China.

METHODS

The performance of the Chinese version of AGSS (C-AGSS) was evaluated among 334 older adults recruited from three community healthcare centers in Beijing, China.

RESULTS

The Cronbach's α was 0.601 and the content validity index was 0.96 for the C-AGSS. The unidimensional model of the scale was supported by the confirmatory factor analysis with an excellent model fit. The concurrent validity was demonstrated by the significant correlation (r=0.614, p<0.001) between the C-AGSS and the Scale of the Elderly Self-neglect (Rural). The hypothesized validity and the discriminative validity of the C-AGSS were also approved.

CONCLUSIONS

The C-AGSS has acceptable validity and reliability on self-neglect assessment in the Chinese older population. It can be used to classify and quantify the self-neglect of older adults in China.

Reliability and validity of the Persian version of the ACE tool: assessing medical trainees' competency in evidence-based medicine

BACKGROUND

Evidence-based medicine (EBM) allows users to integrate evidence into decision-making alongside clinical expertise and patient values. This study aimed to evaluate the reliability and validity of the Persian version of the Assessing Competency in EBM (ACE) tool across knowledge, skills, and attitude.

METHODS

This cross-sectional study was performed on medical residents (first-year residents and junior residents) of Shiraz University of Medical Sciences in 2019. The study instrument was the ACE tool which consists of 15 two-choice questions (yes-no) and each of these questions measures one of four steps in evidence-based medicine (1- asking the answerable question, 2- searching the literature, 3- critical appraisal, and 4- applying the evidence to scenario). This tool was translated into Persian according to international standards. To ensure that the original and translated ACE questionnaire can be matched accurately and conceptuality, content validity index (CVI) and content validity ratio (CVR) were determined. Cronbach's alpha was applied to determine the internal consistency for each scale and Confirmatory factor analysis (CFA) was used to survey the factor structure validity.

RESULTS

One hundred sixty-three questionnaires were studied, selecting 59 first-year medical residents and 104 s-year medical residents. The results showed that using the Persian translation of the ACE tools, the content validity index (CVI) values were equal to or above 0.8 for all items. The content validity ratio (CVR) value was 0.90 for the total scale. The indicators of the confirmatory factor analysis (CFA) for the ACE tool revealed that this model had an acceptable fit. Cronbach's alpha for the overall score was 0.79.

CONCLUSION

The Persian translated version of the ACE tool is a valid and reliable instrument for assessing medical trainees' competency in EBM.

Consumers' self-reported adherence to directions for non-prescription medicines and the role of risk perception

BACKGROUND

Non-prescription medicines (NPMs), while relatively safe, are responsible for a small but significant proportion of medication misadventure and inappropriate use may lead to avoidable healthcare cost. Some consumers vary their use of NPMs from the directions provided on packaging or advice from healthcare professionals. Consumers may use NPMs at lower doses or less frequently than directed because of the risk of side effects.

PURPOSE

This study aimed to develop and validate a self-report measure for the extent to which consumers' follow directions (FDs) for NPMs. Secondly, it aimed to explore the relationship between risk perception towards NPMs and following directions.

METHODS

A cross-sectional study was administered online to participants who belong to an Australian agency which conducts consumer research. Participants were Australian adults who had used NPMs within the last month. Items for the FD-NPM scale were developed and validated. Exploratory factor analysis and confirmatory factor analysis were used to validate the FD-NPM scale. Structural equation modelling (SEM) was employed to explore the relationships between risk perception, covariates, and FDs.

RESULTS

There were 403 participants recruited. Less than 20% "always" or "often" self-reported following directions for dose, frequency, or duration of use. Factor analyses confirmed that there are two moderately positively correlated dimensions of FD-NPM (r = 0.46), which were named underuse and overuse. That is, consumers who self-reported underuse of non-prescription medicines were also more likely to self-report overuse. Consumers with high-risk perception towards NPMs, those who were younger and those who were more educated had a greater tendency to not follow directions.

CONCLUSION

A new self-report measure, the FD-NPM scale was developed and validated. That people who perceives NPMs to be harmful, tend to underuse and more concerningly, overuse them, is of great interest to clinicians and policymakers who are required to manage risk communications.

Attitudinal responses to current concepts and opinions from pain neuroscience education on social media

BACKGROUND

Pain neuroscience education (PNE) programs have become popular among clinicians and are widely promoted through social and mainstream media.

PURPOSE

To test the hypothesis that people with persistent pain are likely to express negative attitudes to PNE statements and compare their responses to other social media user groups.

METHODS

A total of 1319 respondents completed an online survey and were directed into four groups: persistent pain, healthcare professionals with persistent pain, pain-free healthcare professionals, and pain-free controls. The survey included ten statements of popular PNE concepts. Feedback was invited by offering seven attitudinal response categories (three positives, three negatives, and one neutral). A two-step hierarchical regression model was used to assess the likelihood of reporting negatively.

RESULTS

Compared to controls, respondents from the persistent pain group were more likely to report negatively towards all statements (OR 1.6-2.16), except for two statements (#3 and #5). Healthcare professionals were less likely to report negative attitudes for 4 out of 10 statement (OR 0.35-0.58). Health care professionals living with persistent responded to most statements like the pain-free controls (besides statement #2, OR 0.59).

CONCLUSION

People living with persistent pain are more likely to express negative attitudes to PNE statements on social media, unlike healthcare professionals who were less likely to express negativity. Healthcare professionals living with persistent pain responded to most PNE statements like the pain-free control group. The study's main weaknesses include the lack of psychometric information of the questionnaire used, selection bias, small samples of the healthcare professionals and the overrepresentation of young social media users.

Diagnostic Accuracy of the Progressive Collapsing Foot Deformity (PCFD) Classification

BACKGROUND

A consensus group recently proposed the term progressive collapsing foot deformity (PCFD) and a new classification with 2 stages plus 5 classes to describe the complex array of flatfoot deformities. This study aimed to validate different diagnostic accuracy rates of the PCFD classification.

METHODS

This was a survey-based study distributed among 13 foot and ankle fellowship programs for 3 groups of participants with varied experience in practice (group 1: fellows in training, group 2: surgeons in practice for 1-4 years, and group 3: surgeons in practice for ≥5 years). Each participant was asked to assign 20 different cases of flatfoot deformity to the appropriate classes and stages using the PCFD classification. The overall diagnostic accuracy, class, and stage diagnostic accuracy rates for the 20 cases were calculated first for the entire cohort and then compared among the 3 groups. The misdiagnosis rate for each class of deformity (the sum of overdiagnosis and underdiagnosis rates) of the entire cohort was calculated and compared with the other classes. Mean and standard evidence were used to describe numerical data. One-way analysis of variance was used to compare values among the 3 groups and the 5 classes. P <.05 was considered statistically significant.

RESULTS

For the whole cohort, the overall diagnostic accuracy, class diagnostic accuracy, and stage diagnostic accuracy rates were 71.0%, 78.3%, and 81.7%, respectively There was a statistically significant difference between group 1 and 2, and group 1 and 3, in overall diagnostic accuracy and class diagnostic accuracy, with no significant difference among the 3 groups regarding stage diagnostic accuracy. Class B had a significantly higher overdiagnosis rate than the rest of the classes, whereas class D was significantly underdiagnosed than others. The misdiagnosis rates for classes A to E were 3.3%, 17.5%, 11.1%, 26.0%, and 3.7%, respectively.

CONCLUSION

The PCFD classification showed overall fair diagnostic accuracy rates. The highest diagnostic accuracy was for "hindfoot valgus deformity" and "ankle instability." Further content validation of the PCFD classification is needed to examine the terminology and interpretation of those classes with low diagnostic accuracy including "midfoot/forefoot abduction deformity," "forefoot varus deformity/medial column instability," and "peritalar subluxation/dislocation."Level of Evidence: Level II, prospective comparative study.

Reliability and validity of the Korean 12-item Perception of Aggression Scale

WHAT IS KNOWN ON THE SUBJECT?: The importance of and interest in nurses' attitudes towards and subjective experience with workplace violence in clinical settings is increasing. The prevalence of patient-perpetrated violence against Korean nurses in hospital settings is highly prevalent. Only few instruments are available to measure the nurses' perception of patient aggression in Korea. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to assess the linguistic and psychometric reliability and validity of an instrument that evaluates the attitude of Korean nursing staff towards patient-perpetrated workplace violence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This valid and reliable instrument could be used to assess and monitor the nurses' attitudes towards aggressive tendencies in the workplace. The results could contribute to the development of relevant interventions for coping with violence by patients towards nursing staff and the implementation of practical training to cultivate healthy perceptions towards patients to foster therapeutic nurse-patient relationships. ABSTRACT: Introduction Despite the high prevalence of patient-perpetrated violence against Korean nurses globally, reliable and valid measures of patient aggression are lacking in Korean. Aim We translated the 12-item Perception of Aggression Scale (POAS) into Korean and psychometrically assessed its utility in measuring nurses' attitudes towards aggression. Methods The 12-item Korean POAS was obtained through forward-backward translation and cognitive debriefing. It was administered online to 319 nurses (mean age = 32.64 years; females = 96.2%), of which 206 completed it again after two weeks. Confirmatory factor analysis validated the 3-factor structure as hypothesized in the original version. The intra-class correlation coefficient was used to assess the test-retest reliability. Results The originally hypothesized 3-factor structure showed a good fit. The 3 dimensions: aggression as a dysfunctional or undesirable phenomenon, aggression as a functional or comprehensible phenomenon, and aggression as a protective measure had internal consistencies of 0.74, 0.86 and 0.90 and corresponding ICCs of 0.70, 0.86 and 0.90, respectively. Discussion The 12-item Korean POAS is a valid and reliable scale that might aid investigating nurses' attitudes towards patient aggression. Implications for practice The 12-item Korean POAS can help Korean nurses adopt protective behaviours and develop interventions to cope with aggression.

Recent Developments in the Assessment of Nutrition Knowledge in Athletes

PURPOSE OF REVIEW

Adequate nutrition knowledge may influence dietary behaviour, and the performance and health of athletes. Assessment of the nutrition knowledge of athletes can inform practice and provide a quantitative way to evaluate education interventions. This article aims to review nutrition knowledge questionnaires published in the last 5 years to identify advances, possible improvements in questionnaire development and design, and challenges that remain.

RECENT FINDINGS

Twelve new or modified questionnaires were identified. All had undergone validity and reliability testing. Advancements included quantitative measures of content validity and Rasch analysis. Online questionnaires were common, with at least seven using this format. Advances included use of images (n = 2), automated scored feedback (n = 1), and use of applied questions. While advancements have been made in validation and reliability testing and electronic delivery, new questionnaires would benefit from interactive and attractive features including images, provision of electronic feedback, and applied questions.

Validation of the Brazilian version of the Questionnaire for Detection Sick Building Syndrome

OBJECTIVE

To perform content and construct validation of the Questionnaire for Detection Sick Building Syndrome for Health Care Workers in the Brazilian context; and to evaluate the length of employment in relation to the level of exposure to occupational risks that trigger occupational disease.

MATERIALS AND METHOD

This is a methodological and cross-sectional study consisting of the validation of the Questionnaire for Detection Sick Building Syndrome for Brazil, and application of this to health workers. The questionnaire was validated through two axes: content and construct by contrasted groups.

RESULTS

The general index corresponded to 0.81, considering the instrument validated as to content. Fleiss' K index showed an inter-rater agreement of 68.59%, with a free margin of 0.53. Regarding the analysis by contrasted groups, there was a significant association with the two contrasted groups formed time of work in the building and in the sector with some variables described as follows: age group, level of education, time of work in the position, satisfaction with the usual working hours, promotion of workers, among others.

CONCLUSION

It is hoped that the validation of this questionnaire can contribute to a greater visibility of this pathology in the Brazilian Worker's Health scenario.

A Systematic Meta-analysis of the Reliability and Validity of Subjective Cognitive Load Questionnaires in Experimental Multimedia Learning Research

For more than three decades, cognitive load theory has been addressing learning from a cognitive perspective. Based on this instructional theory, design recommendations and principles have been derived to manage the load on working memory while learning. The increasing attention paid to cognitive load theory in educational science quickly culminated in the need to measure its types of cognitive load — intrinsic, extraneous, and germane cognitive load which additively contribute to the overall load. In this meta-analysis, four frequently used cognitive load questionnaires were examined concerning their reliability (internal consistency) and validity (construct validity and criterion validity). Results revealed that the internal consistency of the subjective cognitive load questionnaires can be considered satisfactory across all four questionnaires. Moreover, moderator analyses showed that reliability estimates of the cognitive load questionnaires did not differ between educational settings, domains of the instructional materials, presentation modes, or number of scale points. Correlations among the cognitive load types partially contradict theory-based assumptions, whereas correlations with learning-related variables support assumptions derived from cognitive load theory. In particular, results seem to support the three-factor model consisting of intrinsic cognitive load, extraneous cognitive load, and germane cognitive load. Results are discussed in relation to current trends in cognitive load theory and recommendations for the future use of cognitive load questionnaires in experimental research are suggested.

Development and content validity of a rating scale for the pain and disability drivers management model

Background

Establishing the biopsychosocial profile of patients with low back pain (LBP) is essential to personalized care. The Pain and Disability Drivers Management model (PDDM) has been suggested as a useful framework to help clinicians establish this biopsychosocial profile. Yet, there is no tool to facilitate its integration into clinical practice. Thus, the aim of this study is to develop a rating scale and validate its content, to rapidly establish the patient’s biopsychosocial profile, based on the five domains of the PDDM.

Methods

The tool was developed in accordance with the principles of the COSMIN methodology. We conducted three steps: 1) item generation from a comprehensive review, 2) refinement of the scale with clinicians’ feedback, and 3) statistical analyses to assess content validity.

To validate the item assessing with Likert scales, we performed Item level-Content Validity Index (I-CVI) analyses on three criteria (clarity, presentation and clinical applicability) with an a priori threshold of > 0.78. We conducted Average-Content Validity Index (Ave-CVI) analyses to validate the overall scale with a threshold of > 0.9.

Results

In accordance with the PDDM, we developed a 5-item rating scale (1 per domain) with 4 score options. We selected clinical instruments to screen for the presence or absence of problematic issues within each category of the 5 domains. Forty-two participants provided feedback to refine the scale’s clarity, presentation, and clinical applicability. The statistical analysis of the latest version presented I-CVI above the threshold for each item (I-CVI ranged between 0.94 and 1). Analysis of the overall scale supported its validation (Ave-CVI = 0.96 [0.93;0.98]).

Conclusion

From the 51 biopsychosocial elements contained within the 5 domains of the PDDM, we developed a rating scale that allows to rapidly screen for problematic issues within each category of the PDDM’s 5 domains. Involving clinicians in the process allowed us to validate the content of the first scale to establish the patient’s biopsychosocial profile for people with low back pain. Future steps will be necessary to continue the psychometric properties analysis of this rating scale.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40945-022-00137-2.

Development of central venous access device-associated skin impairment assessment instrument

AIM

To develop an assessment tool to assess the severity and healing of skin impairment with the central venous access device.

DESIGN

Delphi technique.

METHODS

The instrument domain list was developed through a systematic literature review and semi-structured interviews. Experts from China evaluated the relevance and significance of these items in assessing the degree of skin impairment surrounding central venous access device sites through two Delphi rounds. The APA Style JARS checklist for this article was used.

RESULTS

For the systematic literature review, 28 articles were included to develop the wound assessment instrument. From the articles and interview contents, 15 criteria were selected based on reporting frequency. After further screening via in-depth discussion, the central venous access devices associated with the skin impairment assessment tool were refined to include 14 major domains. Through a two-phase Delphi process, 71 items in 12 domains were ultimately retained.

Development of a tool to evaluate medication management guidance provided to carers of people living with dementia at hospital discharge: a mixed methods study

OBJECTIVE

Medication management guidance for carers of people with dementia at hospital discharge is important to prevent medication-related harm during transitions of care. This study aimed to develop a tool to evaluate medication management guidance provided to carers of people with dementia at hospital discharge.

DESIGN

The tool was developed using mixed methods involving two stages. Stage 1 involved item generation and content validation. Items were based on a previous qualitative study and systematic review. Content validation involved experts and consumers with knowledge or experience of medication management guidance in the acute care setting, and rating each item on importance and relevance. Stage 2 involved conducting cognitive interviews with carers of people with dementia to pretest the tool.

SETTING

For stage 1, experts and consumers from Australia, USA and New Zealand were included. For stage 2, carers of people with dementia were recruited across Australia.

PARTICIPANTS

18 experts and consumers participated in round 1 of content validation, and 13 experts and consumers completed round 2. Five carers of people with dementia participated in cognitive interviews.

RESULTS

The final tool contained 30 items capturing information across five domains: (1) provision of medication management guidance at hospital discharge; (2) carer understanding of medication management guidance provided at discharge; (3) carer engagement in discussing the safe use of medications at discharge; (4) carer preparedness to conduct medication management activities after discharge; and (5) co-ordination of medication management guidance after discharge.

CONCLUSIONS

We developed the first tool to assess medication management guidance provided for carers of people with dementia at hospital discharge. The tool may be useful to inform future research strategies to improve the delivery of medication management guidance at discharge.

Checklists for Assessing Skills of Children With Type 1 Diabetes on Insulin Injection Technique

BACKGROUND

School-aged children often participate in type 1 diabetes (T1D) self-care tasks. Despite widespread discussion about the importance of developing self-care skills in childhood, few explain how the health care team should assess the skills of children with T1D when performing insulin injections.

OBJECTIVE

We sought to assess content validity evidence in two checklists regarding injection technique performed by children.

METHODS

Two checklists were designed based on a systematic review of the insulin injection technique. Experts in pediatric diabetes, health literacy, and diabetes education assessed the checklists regarding their clarity, objectivity, and relevance. Content validity was assessed using the content validity ratio (CVR).

RESULTS

Eleven providers (72% nurses or physicians, professional experience 19.4 ± 10.1 years, 45% of specialists in endocrinology, and 18% in pediatrics) participated in the assessment. Experts considered items containing the word homogeneity inappropriate. Items related to the needle insertion angle and the skin fold did not reach the CVR critical value. The final version of the checklist for syringe injection comprised 22 items with CVR = 0.91, and the checklist for pen injection comprised 18 items with CVR = 0.87.

CONCLUSIONS

The checklists presented clear, objective, and relevant content that assesses the skills of children with T1D for insulin injection. The checklists formally present the order of the technique and all the steps for insulin injection and allow a quantitative assessment of the operational skills of children. The developed instruments offer providers the possibility of continuous assessment of the progress of the pediatric clientele until they reach independence in diabetes self-care.

Content Validity through Expert Judgment for the Depression Clinical Evaluation Test

Background/Objective

The evaluation of depression requires valid and reliable measuring instruments, which collect a wide spectrum of symptoms that this disorder displays, in order to carry out an accurate and differential diagnosis. The objective of this work is the construction of the Depression Clinical Evaluation Test (DCET), where affective, somatic, cognitive, behavioral and interpersonal symptoms are considered and also analyze its content validity through an expert judgment.

Method

Based on different diagnostic and manual classifications, a specification table for a depression test was established. In its evaluation, 16 experts in Psychological Assessment, Psychometry and/or Psychopathology participated. A total of 300 items were created. The experts had to assess the items according to the criteria of Content, Relevance, Clarity, Comprehension, Sensitivity, and Offensiveness. In addition, 50 adults, evaluated the compression of the items.

Results

The degree of understanding for all the items was high and the expert judgment favoured the suppression of 104 items, thus obtaining a shorter measuring instrument with a total of 196 items for ease of application.

Conclusions

The content validity of the test is adequate and fits the agreed definition of depression.

Ecuadorian university English teachers' reflections on emergency remote teaching during the COVID-19 pandemic

COVID-19 struck at the beginning of 2020, affecting, among others, the education industry. As a result, a lock-down quarantine was declared, and on-campus classes were suspended. Accordingly, emergency remote teaching (ERT) was set into motion to solve the education issue. This research aimed to obtain the reflections of 20 Ecuadorian polytechnic university English teachers on their experiences using ERT during two semesters. This paper is based on an explanatory sequential mixed-methods research design that used a Likert-scale survey and interviews to respond to the established research questions. The findings show that, in a general sense, teachers were not ready for the sudden shift to ERT, which generated feelings of anxiety. The most significant disadvantage reported was the extra workload caused by adapting materials and giving feedback to students. The study suggests that changing classes from on-campus to ERT was not easy to carry out at the beginning of the pandemic. There are practical implications for language department managers as it gives them light to prepare for the continuing pandemic and any other crisis that might require ERT to be in practice again.

An exploratory study of outpatient medication knowledge and satisfaction with medication counselling at selected hospital pharmacies in Northwestern Nigeria

Background

Medication counselling is an important activity that improves patient therapeutic outcomes. After this activity has been carried out, patients should be satisfied with counselling, and possess adequate knowledge about their medications.

Objectives

To describe outpatient/caregiver medication knowledge and satisfaction with medication counselling at the main outpatient pharmacies of eight public secondary and tertiary hospitals located in two states in Northwestern Nigeria.

Methods

Exit interviews were conducted from December 2019 to March 2020 with randomly sampled patients/caregivers who had just been dispensed one or more prescription medications from the main pharmacies of the hospitals. The questionnaire used contained 31 questions in three sections. The first section collected demographic information. The second section assessed respondents’ experiences and overall satisfaction with the counselling they had received. The last section evaluated respondents’ knowledge of one randomly selected prescription medication that had been dispensed to them. Data collected were coded and analyzed to generate descriptive statistics. To explore associations between respondent characteristics and overall satisfaction, non-parametric tests were used, and statistical significance set at p<0.05.

Results

A total of 684 patients/caregivers were interviewed. Majority of respondents agreed that the time spent (97.1%) and quantity of information (99.1%) provided during counselling was adequate. However, over 60% of them also agreed that dispensers did not assess their understanding of information provided or invite them to ask questions. Despite this, their average overall satisfaction with counselling on a 10-point scale was 8.6 ± 1.6. Over 90% of them also correctly identified the routes and frequency of administration of the prescribed medication selected for the knowledge assessment. Although, more than 60% of respondents did not know the duration of therapy or names of these medications.

Conclusion

Respondents’ satisfaction with medication counselling was fairly high even though they did not seem to know much about their medication.

Barriers to the implementation of the UNIDO’s program for export consortia: a case study of the Iranian handmade carpet industry

Purpose

This paper aims to identify and analyze the barriers to the implementation of the United Nations Industrial Development Organization’s programxk for export consortia in the Iranian handmade carpet industry.

Design/methodology/approach

To accomplish its objectives, the study relied on a mixed (qualitative and quantitative) research method. Primarily, unstructured interviews were conducted to identify the effective barriers. Then, the validity of the barriers identified was evaluated through content validity ratio analysis. Finally, the interrelationships between the barriers were determined using the rough decision-making trial and evaluation laboratory technique (DEMATEL).

Findings

Results revealed that “a lack of leadership,” “a traditional business environment” and “a lack of awareness of consortium benefits” were the most significant causal barriers. Meanwhile, the most important effect barriers were “a lack of long-term vision,” “a lack of business ethics” and “a lack of motivation.”

Practical implications

The findings and results could help the stakeholders of the handmade carpet industry in Iran to improve existing export consortium programs, increasing the country’s share in the global markets in this industry.

Originality/value

This investigation seeks to fill an existing gap in the literature on export consortium formation in the handmade carpet industry by providing a network of barriers for the first time.

The Chinese version of the Quality of Life in Childhood Epilepsy Questionnaire-16-C (QOLCE-16-C): translation, validity, and reliability

Background

Epilepsy is one of the most common chronic neurological diseases that adversely impact the quality of life of patients and their families. The “Quality of Life of Childhood Epilepsy Questionnaire” (hereinafter referred to as “QOLCE-16”) is a 16-item measure that was designed to assess health-related quality of life (HRQOL) among children with epilepsy. The purpose of the study was to translate and evaluate the psychometric properties of the QOLCE-16.

Methods

The 10 steps of Principles of Good Practices for translation and cultural adaptation of measures were adopted to translate the QOLCE-16 into Chinese. After that, item analysis, floor effect and ceiling effect, internal consistency, test–retest reliabilities, content validity and construct validity were conducted to test its applicability in children with epilepsy in China. A total of 435 native Chinese-speaking parents with children who had epilepsy from one children’s hospital were invited to take part in the study, including a cognitive interview sample of 5 and a validation sample of 430.

Results

A total of 414 objects were enrolled in our study for psychometric testing. The results of the item analysis revealed QOLCE-16-C to have good discrimination, the floor effect and ceiling effect were 0.2% and 1.0% respectively, and each item was significantly related to the total scale (P < 0.001). The Cronbach’s α value was 0.938 and the test–retest reliability was 0.724. For validity, results showed that the QOLCE-16-C had good content validity. Exploratory factor analysis indicated it was reasonable that the QOLCE-16-C consists of four dimensions after rotation. Confirmatory factor analysis demonstrated good construct validity (χ²/df = 1.698, GFI = 0.913, CFI = 0.974, RMSEA = 0.058).

Conclusion

The Chinese version of QOLCE-16-C appears to be a culturally appropriate, valid and reliable tool to assess the health-related quality of life of children with epilepsy in China.

Sustainable Development: Smart Co-Operative Management Framework

A smart co-operative refers to a co-operative that aims to apply ICT to provide better services and increase management efficiency to meet organizations’ goals through the combinations of ICT technology and business. In this paper, we propose the sustainable development smart co-operative framework, which specifically applies to all types of co-operatives which use information technology in their organization, enabling transformation to improve their services, management, and governance. In addition, we discuss ICT channel creation for improving knowledge, awareness, democracy, and the participation of members, a process in which IT contributes to the accessibility of members and communication between the co-operative, members, and stakeholders. The element design of this proposed framework has considered three key principles, which are (1) smart members, (2) the smart economy, and (3) smart governance. A smart co-operative is a term used to extend the concept of a smart city into co-operative organization to promote a sustainable development approach in the co-operative sector. Therefore, the smart co-operative combines ICT, smart concepts, co-operative business aspects, business models, and innovation. The findings suggest that the smart and sustainable development co-operative framework is suitable for co-operatives, providing a comprehensive framework for value creation through the smart co-operative concept.

Development of the Japanese Version of the Infertility Stigma Scale: Examination of Its Reliability and Validity

The stigma of infertility negatively affects health, resulting in mental distress and poor quality of life. An appropriate scale is essential to examine the stigma experienced by infertile women and provide adequate interventions. Therefore, we developed a Japanese version of the Infertility Stigma Scale (ISS). After examining the content validity of this scale, we conducted an online survey of women undergoing fertility treatment to test the scale’s structural validity, internal consistency, intra-rater reliability, known-groups validity, convergent validity, and discriminant validity. A total of 254 participants were included in the analysis. The results of confirmatory factor analysis of four factors based on the original scale revealed the optimal fit. Cronbach’s alpha was 0.95 for the total score. Concerning test−retest analysis, the total score of the ISS and subscale had a high Spearman correlation coefficient (ρ = 0.61−0.88, p < 0.001). For convergent validity, the association between the ISS and social support, self-esteem, and family functioning was significantly negatively correlated. The results of the multitrait scaling analysis scale showed that correlations of all items exceeded 0.40, and scaling errors (7/81, 8.6%) were few. The Japanese version of the ISS was confirmed to have acceptable reliability and validity.

Development and validation of patients' surgical safety checklist

Background

Poor uptake and understanding of critical perioperative information represent a major safety risk for surgical patients. Implementing a patient-driven surgical safety checklist might enhance the way critical information is given and increase patient involvement in their own safety throughout the surgical pathway. The aim of this study was to develop and validate a Surgical Patient Safety Checklist (PASC) for use by surgical patients.

Method

This was a prospective study, involving patient representatives, multidisciplinary healthcare professionals and elective surgical patients to develop and validate PASC using consensus-building techniques in two Norwegian hospitals. A set of items intended for PASC were rated by patients and then submitted to Content Validation Index (CVI) analyses. Items of low CVI went through a Healthcare Failure Mode and Effect Analysis (HFMEA) Hazard Scoring process, as well as a consensus process before they were either kept or discarded. Reliability of patients’ PASC ratings was assessed using Intraclass Correlation Coefficient analysis. Lastly, the face validity of PASC was investigated through focus group interviews with postoperative patients.

Results

Initial development of PASC resulted in a checklist consisting of two parts, one before (32 items) and one after surgery (26 items). After achieving consensus on the PASC content, 215 surgical patients from six surgical wards rated the items for the CVI analysis on a 1-4 scale and mostly agreed on the content. Five items were removed from the checklist, and six items were redesigned to improve PASCs’ user-friendliness. The total Scale-level index/Average (S-CVI/Ave) before revision was 0.83 and 0.86 for pre- and post-operative PASC items, respectively. Following revision, these increased to 0.86 and 0.93, respectively. The PASC items reliability score was 0.97 (95% confidence interval 0.96 to 0.98). The qualitative assessment identified that patients who used PASC felt more in control of their situation; this was achieved when PASC was given to them at what they felt was the right time and healthcare professionals took part in its usage.

Conclusion

Multidisciplinary perioperative care staff and surgical patients agreed upon PASC content, the checklist ratings were reliable, and qualitative assessment suggested good face validity. PASC appears to be a usable and valid checklist for elective surgical patients across specialties.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07470-z.

Development and Validation of Structured COVID Perception Interview Guide (COPING) for Assessing the Acute Impact of COVID-19 Diagnosis

Objective  Structured COVID Perception INterview Guide (COPING) is a novel tool developed to understand the acute impact after receiving the diagnosis of coronavirus disease 2019 (COVID-19) in the Indian setting. The approach carries importance for interviewing patients in a state of shock immediately after receiving the diagnosis of COVID. The tool is developed emphasizing the grief, stigma, and acute psychological perception in the immediate aftermath of receiving the positive test results of COVID-19. Since COVID-19 is characteristically different from other infectious illnesses, a structured interview guide could help to address the concerns related to acute loss of health.

Materials and Methods  This study follows a mixed method design conducted from August 2020 to January 2021. In-depth telephonic interviews with mild to moderate COVID patients admitted to a tertiary hospital in central India was followed by development of COPING questionnaire.

Statistical Analysis  Item-Content Validity Index (I-CVI) and Scale-Content Validity Index Universal Agreement (S-CVI/UA) was computed. Factor analysis, Bartlett's test, and Kaiser–Meier–Olkin measure of sampling adequacy was performed. Principal component analysis, scree plots, and parallel analysis with varimax rotation was used to determine the number of factors to extract. For measuring internal consistency, Cronbach's α was computed.

Results  Out of 40 items, the final tool had 15 items after computing content validity, performing factor analysis and achieving desired level of internal consistency (Cronbach's α  = 0.702). Five domains identified after factor analysis were awareness, grief/bereavement, stigma, social reciprocity, and stress adaptation/coping.

Conclusion  COPING is a valid and reliable interview guide for Indian setting that will allow the assessment of perception of patients with acute COVID-19 infection. Taking into consideration the mental health implications of COVID-19, the availability of such a validated and reliable tool is a timely step to address the public health problem and assist the ongoing research on COVID-19 and similar illnesses in the future.

Content validation of value-adding indicators for corporate real estate management: insights from a developing country

Purpose

The purpose of this study is to test the content validity of value-adding indicators derived from a comprehensive review of literature and expert interviews within the context of the nascent corporate real estate management (CREM) practices in Ghana.

Design/methodology/approach

A questionnaire survey was conducted on a panel of experts to assess the content relevance and clarity of the value-adding indicators. The individual content validity (I-CVI) index as well as the average scale content validity index (S-CVI) were computed. Preliminary interviews were analyzed using summative content analysis.

Findings

The I-CVI for relevance and clarity ranged from 0.33 to 1.00, whereas the average S-CVI was > 0.80. Critical analysis of the results by corrections, eliminations due to lower I-CVI scores and suggestions from the experts resulted in a final list of 50 indicators grouped under 10 domains. The results from the content validity confirm the applicability of the value-adding indicators in literature within the Ghanaian context. The study provides detailed sustainability indicators while introducing a new value-adding parameter that relates to CREM preparedness for pandemics such as the Covid-19.

Research limitations/implications

Further psychometric assessment such as construct validity, inter- and intra-examiner reliability and internal consistency of the indicators is recommended.

Practical implications

The indicators developed through the content validation can assist in the design and review of measures for the assessment of added value by corporate real estate managers and researchers.

Originality/value

The paper presents the first attempt to test and develop added value indicators within the context of a developing country by taking a systematic content validation procedure.

Validity and reliability of the novel three‐item occupational violence patient risk assessment tool

Aim

To develop and psychometrically test an occupational violence (OV) risk assessment tool in the emergency department (ED).

Design

Three studies were conducted in phases: content validity, predictive validity and inter‐rater reliability from June 2019 to March 2021.

Methods

For content validity, ED end users (mainly nurses) were recruited to rate items that would appropriately assess for OV risk. Subsequently, a risk assessment tool was developed and tested for its predictive validity and inter‐rater reliability. For predictive validity, triage notes of ED presentations in a month with the highest OV were assessed for presence of OV risk. Each presentation was then matched with events recorded in the OV incident register. Sensitivity and specificity values were calculated. For inter‐rater reliability, two assessors—trained and untrained—independently assessed the triage notes for presence of OV risk. Cohen's kappa was calculated.

Results

Two rounds of content validity with a total of N = 81 end users led to the development of a three‐domain tool that assesses for OV risk using aggression history, behavioural concerns (i.e., angry, clenched fist, demanding, threatening language or resisting care) and clinical presentation concerns (i.e., alcohol/drug intoxication and erratic cognition). Recommended risk ratings are low (score = 0 risk domain present), moderate (score = 1 risk domain present) and high (score = 2–3 risk domains present), with an area under the curve of 0.77 (95% confidence interval 0.7–0.81, p < .01). Moderate risk rating had a 61% sensitivity and 91% specificity, whereas high risk rating had 37% sensitivity and 97% specificity. Inter‐rater reliability ranged from 0.67 to 0.75 (p < .01), suggesting moderate agreement.

Conclusions

The novel three‐domain OV risk assessment tool was shown to be appropriate and relevant for application in EDs. The tool, developed through a rigorous content validity process, demonstrates acceptable predictive validity and inter‐rater reliability.

Impact

The developed tool is currently piloted in a single hospital ED, with a view to extend to inpatient settings and other hospitals.

Associations between Physical Activity and Academic Competence: A Cross-Sectional Study among Slovenian Primary School Students

Physical activity has beneficial effects on overall academic performance in children. However, there is a lack of evidence regarding how the individual characteristics of physical activity interact with other confounding variables of academic competence. Leisure-time physical activity with potential confounders-such as developmental, behavioral, family, and school factors, predicting overall, mathematical, and reading academic competence-was studied in a random sample of 1520 Slovenian primary school students in grades 4-6 (51.9% female; mean age = 10.4 years; SD = 0.93). A structured self-reported questionnaire was used to gather data on the children's leisure-time physical activity and social-demographic variables, while academic competence was measured by teachers using the SSRS Academic Competence Evaluation Scale. The findings showed that children engage in physical activity most days a week, with moderate-intensity and unorganized activities. It was predicted that engaging in physical activity would lead to an increase in academic performance by 4.2% in males (p = 0.002) and 3.2% in females (p = 0.024), but after fully adjusting the model for controlling confounding variables, the prediction increased to 81.1% in females and 84.1% in males (p < 0.001). The frequency and intensity of physical activity, the absence of digital games, and attending sports clubs seem to have the most beneficial effects in terms of academic competence in school children, among other relevant confounders mediating in this complex relationship.

Desenvolvimento e validação de aplicativo móvel para o autocuidado de pessoas com insuficiência cardíaca

RESUMO Objetivo: Desenvolver e verificar as evidências de validade de conteúdo e face de um protótipo de aplicativo móvel para o autocuidado de pessoas com insuficiência cardíaca. Método: Estudo de desenvolvimento tecnológico baseado no Design Instrucional Contextualizado. Na etapa de validação, seis enfermeiros especialistas em cardiologia avaliaram o conteúdo por meio do Suitability Assessment of Materials e 13 pessoas com insuficiência cardíaca realizaram avaliação de face, pelo índice de validade de conteúdo. Os dados foram analisados por meio de estatística descritiva. Resultados: O protótipo do aplicativo, nomeado “Tum Tum”, possui interface e telas de livre navegação que abordam o conceito da insuficiência cardíaca, causas, sinais e sintomas, diagnóstico e tratamento. Apresenta mosaico com orientações educativas, recursos para o reconhecimento precoce de sinais de descompensação clínica, registro para controle do peso corporal, lembretes para o uso de medicamentos, agenda de consultas e exames. A tecnologia mostrou-se adequada entre especialistas e público-alvo. Conclusão: Foi possível desenvolver e validar o conteúdo e face do protótipo do aplicativo “Tum Tum”, que demonstra potencial para promover o autocuidado em pessoas com insuficiência cardíaca.

Ecuadorian university English teachers' reflections on emergency remote teaching during the COVID-19 pandemic

COVID-19 appeared at the beginning of 2020, affecting, among others, the education industry. As a result, a lock-down quarantine was declared, and on-campus classes were suspended. Accordingly, emergency remote teaching (ERT) was set into motion to solve the education issue. This investigation surveyed 20 Ecuadorian polytechnic university English teachers and obtained their reflections on their experience with ERT. This paper bases on mixed-methods research that used a Likert-scaled survey and interviews to respond to the established research questions. The results show that, in a general sense, teachers were not ready for the sudden shift to ERT, which generated feelings of anxiety. The most significant disadvantage reported was the extra workload caused by adapting materials and giving feedback to students. COVID-19 struck at the beginning of 2020, affecting, among others, the education industry. As a result, a lockdown quarantine was declared, and on-campus classes were suspended. Accordingly, emergency remote teaching (ERT) was set into motion to solve the education issue. This research aimed to obtain the reflections of 20 Ecuadorian polytechnic university English teachers on their experiences using ERT during two semesters. This paper is based on an explanatory sequential mixed-methods research design that used a Likert-scale survey and interviews to respond to the established research questions. In a general sense, the findings show that teachers were not ready for the sudden shift to ERT at the beginning of the pandemic, which generated feelings of anxiety. The most significant disadvantage reported was the extra workload caused by adapting materials and giving feedback to students. The study suggests that changing classes from on-campus to emergency remote teaching was not easy to carry out at the beginning of the pandemic. There are practical implications for language department managers as it gives them light to prepare for the continuing pandemic and any other crisis that might require ERT to be in practice again.

A experiência da segunda vítima: adaptação transcultural de um instrumento para o contexto brasileiro

RESUMO Objetivo Adaptar transculturalmente e analisar as evidências de validade de conteúdo do Second Victim Experience and Support Tool para a língua portuguesa falada no Brasil. Método Estudo psicométrico de adaptação transcultural, seguindo as etapas do Patient-Reported Outcome Measurement Information System. Foram avaliadas as equivalências semântica, idiomática, experimental e conceitual. A validade de conteúdo foi verificada, com base no Content Validity Ratio. Participaram do pré-teste 31 profissionais de saúde da cidade de São Paulo. Resultados A análise das equivalências apresentou uma taxa de concordância de 88,7%. A validade de conteúdo apresentou 86% dos itens com valores de Content Validity Ratio acima do estipulado. No pré-teste, os participantes reportaram terem entendido os itens do instrumento e apenas 10% dos participantes relataram dificuldade para entender algum item. Conclusão A versão brasileira do Questionário de Experiência e Apoio à Segunda Vítima apresentou boa qualidade de tradução e boas evidências de validade de conteúdo.

Revision and Validation of the Chinese Version of the McGill Quality of Life Questionnaire for ICU End-of-Life Patients

BACKGROUND

Hospice care for end-of-life patients in the ICU should focus on quality of life. Currently, there are no specific quality-of-life measures for ICU end-of-life patients in China.

OBJECTIVE

The aim of this study was to revise and culturally adapt the Taiwanese version of the McGill Quality of Life Questionnaire (MQOL-Taiwan) and to test its reliability and validity to provide an effective instrument for assessing the quality of life of ICU patients at the end of life.

METHODS

The revision and cultural adaptation of the MQOL-Taiwan were performed to develop a Chinese version of the McGill Quality of Life Questionnaire for ICU end-of-life patients (MQOL-ICU). A total of 156 ICU doctors, 286 ICU nurses and 120 ICU family members of end-of-life patients were surveyed with the revised scale to evaluate the quality of life of ICU patients at the end of life. The content validity, construct validity, and internal consistency of the scale were measured after the revision.

RESULTS

The Chinese version of the MQOL-ICU scale was formed based on the MQOL-Taiwan scale, which includes 8 items. For the Chinese version of the MQOL-ICU, the item-content validity index (I-CVI) ranged from 0.789 to 0.905, and the average scale-level content validity index (S-CVI/Ave) was 0.845. After exploratory factor analysis, the Kaiser-Meyer-Olkin (KMO) value was 0.700, and 3 dominant factors were extracted: physical and psychological symptoms, existential well-being, and support. In addition, 70.385% of the total variance was explained. The internal consistency (Cronbach's α) coefficient of the whole MQOL-ICU was 0.804, and the coefficients for the 3 domains ranged from 0.779 to 0.833.

CONCLUSION

The Chinese version of the MQOL-ICU showed good reliability and validity, and it can be used to assess the quality of life of ICU patients at the end of life.

Improved Functional Outcome Scores Associated with Greater Reduction in Cam Height Using the Femoroacetabular Impingement Resection Arc During Hip Arthroscopy

PURPOSE

We sought to evaluate the association between postoperative cam lesion measured by the femoroacetabular impingement resection (FAIR) arc and show 2-year patient outcomes following hip arthroscopy.

METHODS

A retrospective review of prospectively gathered data from 2013-2017 was performed. All patients who underwent hip arthroscopy for femoroacetabular impingement resection (FAI) with ≥2-year follow-up were included. Cam FAIR arc measurements were made preoperatively and postoperatively on a 45° Dunn view radiograph. The clinical effect of postoperative cam maximal radial distance (MRD) was assessed using the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS). Patients were divided into subgroups based on relationship to the mean and standard deviations for cam MRD. One half standard deviation above the mean was found to be 3.15 mm.

RESULTS

Sixty-one hips in 59 consecutive patients (age 38.1 ± 13.1; body mass index [BMI]: 25.5 ± 4.3; 36 females) were included. Mean preoperative and postoperative cam maximal radial distances (MRD) were 4.5 ± 1.7 mm and 2.3 ± 1.7 mm (P < .001), respectively. The interclass correlation coefficient was excellent (>.9) for all measurements. There were no differences in age, sex, BMI or preoperative mHHS/NAHS between <3.15 mm and >3.15 mm cam MRD groups (P > .05). Using linear regression, cam MRD was found to be significantly associated with 2-year outcomes for both mHHS (R² = .21, P < .001) and NAHS (R² = .004). Subgroup analysis demonstrated that patients in the cam MRD < 3.15 mm group had significantly higher mHHS (89.7 vs 70.0, P < .001) and NAHS scores (90.5 vs 72.9, P < .001) than those in the >3.15 mm group. Additionally, more patients in the <3.15 mm group reached the minimal clinically important difference (95.2% vs 78.9%, P = .048) and were above patient acceptable symptomatic state (95.2% vs 52.6%, P < .001) compared to the >3.15 mm group.

CONCLUSION

Patients with a lower postoperative cam MRD relative to the FAIR arc demonstrated significantly improved outcomes as compared to those with higher postoperative MRD at two-year follow-up.

LEVEL OF EVIDENCE

Level IV, retrospective case series.

Development and validation of inventory tool to evaluate social accountability principles in case scenarios used in problem-based curriculum (Social accountability inventory for PBL)

Social accountability (SA) is an obligation for medical schools in meeting the priority health concerns of the communities they serve. To measure the integration of SA principles into medical curricula, suitable tools are needed. This study developed and validated an inventory to assess SA values within the existing case scenarios used in problem-based learning (PBL) curricula. The Delphi technique was employed to develop and validate the new inventory. The validation used expert opinion and calculated the content validity using content validity indices (CVIs). The initial draft (Draft 0) was formulated with 25 open-ended questions. Following expert evaluation, Draft 1 had 22 closed-ended questions and the mean ratings, according to the experts, were as follows: relevance, 3.33-4.83; importance (3.5-4.8); clarity (3.33-4.83); and simplicity (3:00-4.67). Draft 2 had 19 questions. After a further round of rating and analysis, a final draft was prepared, consisting of 17 items, with CVI scores ≥ 0.8 and 100% overall satisfaction. Using this inventory tool will help health professions schools to translate SA indicators into curricular activities by identifying the gaps in their PBL curricula. Deficiencies can be either in the type of case scenarios used or the triggers embedded in the individual case scenarios, subsequently leading to the development of PBL case scenarios that address real health social needs. A revision and rewriting of the problem case scenarios to incorporate SA will be the next step.

Measuring quality of pre-hospital traumatic shock care-development and validation of an instrument for resource-limited settings

BACKGROUND AND AIMS

Improving the quality of pre-hospital traumatic shock care, especially in low- and middle-income countries, is particularly relevant to reducing the large global burden of disease from injury. What clinical interventions represent high-quality care is an actively evolving field and often dependent on the specific injury pattern. A key component of improving the quality of care is having a consistent way to assess and measure the quality of shock care in the pre-hospital setting. The objective of this study was to develop and validate a chart abstraction instrument to measure the quality of trauma care in a resource-limited, pre-hospital emergency care setting.

METHODS

Traumatic shock was selected as the tracer condition. The pre-hospital quality of traumatic shock care (QTSC) instrument was developed and validated in three phases. A content development phase utilized a rapid literature review and expert consensus to yield the contents of the draft instrument. In the instrument validation phase, the QTSC instrument was created and underwent end user and content validation. A pilot-testing phase collected user feedback and performance characteristics to iteratively refine draft versions into a final instrument. Accuracy and inter- and intra-rater agreement were calculated.

RESULTS

The final QTSC instrument contains 10 domains of quality, each with specific criteria that determine how the domain is measured and the level of quality of care rendered. The instrument is over 90% accurate and has good inter- and intra-rater reliability when used by trained pre-hospital provider users in South Africa. Pre-hospital provider user feedback indicates the tool is easy to learn and quick to use.

CONCLUSION

We created and validated a novel chart abstraction instrument that can reliably and accurately measure the quality of pre-hospital traumatic shock care. We provide a systematic methodology for developing and validating a quality of care tool for resource-limited care settings.

Content Validation of an Algorithm for the Assessment, Management and Monitoring of Drug-Induced QTc Prolongation in the Psychiatric Population

BACKGROUND

QTc interval (QTcI) prolongation leads to serious complications, making it a concern for clinicians. Assessing the risk of QTcI prolongation in the psychiatric population is important because they are exposed to multiple medications known to increase the risk of life-threatening arrhythmias.

AIM

The study aims to validate the content of an algorithm for the assessment, management and monitoring of drug-induced QTc prolongation in the psychiatric population.

METHODOLOGY

Qualitative semi-structured interviews of cardiologists, to gather information regarding their approach in assessing the risk of drug-induced QTc prolongation at the time of prescribing. After the interview, an orientation to the algorithm was provided with a link to a cross-sectional, anonymous survey. The online survey included quantitative and qualitative components to gather feedback on the relevance and appropriateness of each step in the algorithm.

RESULTS

Interview responses were incorporated into 4 themes. Responses indicated a lack of a unified protocol when assessing QTcI prolongation, which supports the need of an algorithm that includes a verified risk scoring tool. Quantitative survey results showed a mean score ranging from 3.08 to 3.67 out of 4 for the appropriateness of the algorithm's steps, 3.08 to 3.58 for the safety and 3.17 to 3.75 for the reliability of references used. Additional analysis using the modified kappa and I-CVI statistical measures indicate high validity of contents and high degree of agreement between raters. As per the open-ended questions, cardiologists supported the implementation of the algorithm; however, they recommended simplification of the steps as they appear to be cumbersome.

CONCLUSION

The results demonstrate that the implementation of the algorithm after minor alterations can prove to be useful as a tool for the risk assessment of QTc prolongation. Further validation of the algorithm with mental health pharmacists and clinicians will be conducted as a separate phase of the study.

Development, reliability and validity of infectious disease specialist Nurse's Core competence scale

Aim

This study aims to develop an instrument to measure infectious disease specialist nurses’ core competence and examining the scale’s validity and reliability.

Background

With the increase of infectious diseases, more and more attention has been paid to infectious disease nursing care. The core competence of the infectious disease specialist nurses is directly related to the quality of nursing work. In previous researches, infectious disease specialist nurses’ core competence was measured by the tools developed for general nurses instead of specialized tools, which made it difficult to clarify the core competence of nurses in infectious diseases department.

Methods

Preliminary items were developed through literature review, theoretical research, qualitative interview and Delphi method. The confirmed 47 items were applied in the two rounds of data collection. Evaluation data on 516 infectious disease specialist nurses’ core competence in the first round were utilized to preliminarily evaluate and explore the scale’s constrution, while evaluation data on 497 infectious disease specialist nurses’ core competence in the second round were utilized to do reliability analysis and validity analysis. In this study, factor analysis, Cronbach’s α, Pearson correlation coefficients were all adopted.

Results

The final scale is composed of 34 items and 5 factors, and adopted the 5-point scoring method. The factors are Professional Development Abilities, Infection Prevention and Control Abilities, Nursing Abilities for Infectious Diseases, Professionalism and Humanistic Accomplishment, and Responsiveness to Emergency Infectious Diseases. The explanatory variance of the five factors was 75.569%. The reliability and validity of the scale is well validated. The internal consistency, split-half reliability and test-retest reliability were 0.806, 0.966 and 0.831 respectively. The scale has good structural validity and content validity. The content validity was 0.869. Discrimination analysis showed that there were significant differences in the scores of core competence and its five dimensions among infectious disease specialist nurses of different ages, working years in infectious diseases, titles, educational background, marital status and wages (all P < 0.05).

Conclusions

The proposed scale takes on high reliability and validity, and is suitable for assessing the infectious disease specialist nurses’ core competence.

Relevance to clinical practice

This scale provides a reference for clinical assessment of infectious disease nursing.

Effects of family-based dignity intervention and expressive writing on anticipatory grief of family caregivers of patients with cancer: a study protocol for a four-arm randomized controlled trial and a qualitative process evaluation

BACKGROUND

Family caregivers of dying cancer patients are affected by grief experiences and bereavement complications. Several approaches such as psycho-emotional care and an increase in spirituality have been suggested to diminish these complications. However, the knowledge about the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients is limited. This is a study protocol describing a hospital-based mixed-methods study on the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients.

METHODS

This mixed-methods study will be done in an embedded explanatory design with two quantitative and qualitative phases. In the first phase (quantitative), a randomized clinical trial will be done, in which 200 family caregivers of dying cancer patients will be randomly assigned to one of the four groups: family-based single dignity intervention (group 1), expressive writing intervention (group 2), combined family-based single dignity intervention and expressive writing (group 3), and control (group 4). At baseline, 1 week and 2 weeks after the interventions, anticipatory grief will be assessed by a 13-item anticipatory grief scale. After the quantitative phase, the qualitative phase will be conducted through the conventional content analysis approach of Granheim and Lundman, in which an individual semi-structured interview will be taken from participants in the first phase to collect data on their experiences on interventions. Finally, data from the quantitative and qualitative phases will be analyzed and discussed.

DISCUSSION

Family caregivers of dying cancer patients usually experience depression, anxiety, and psychological distress due to isolation and inadequate social support. Psychological interventions such as dignity and expressive writing interventions may help caregivers to obtain a better understanding of themselves and to increase their abilities to cope with caregiving difficulties. Therefore, there is a need for a comprehensive study confirming the effects of mentioned interventions on family caregivers of dying cancer patients.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials ( www.irct.ir ) identifier: IRCT20210111050010N1. Date of trial registration: Feb 6, 2021. This is the first version of this protocol.

Self-evaluating participatory research projects: A content validation of the InSPIRES online impact evaluation tool

Research projects involving science shops and citizen science in their promotion of participatory approaches are flourishing globally. However, an instrument evaluating the impacts of such approaches at different stages of a participatory research processes has yet to be validated. The InSPIRES H2020 project developed an impact evaluation tool for just this purpose, consisting of 64 items that reflect upon the dimensions of knowledge democracy, citizen-led research, participatory dynamics, transformative change, and integrity. In this article, we seek to test the content validity of this tool and to provide recommendations that can ensure its validity. A panel of nine experts was created to evaluate each item as regards the following three criteria: representativeness, relevance, and clarity. The Aiken’s V and Wilson Score methods were used to assess the tool’s content validity based on the experts’ ratings. Experts’ written comments were also reviewed. At the panel level, 75% of the items were considered satisfactory in relation to each of the three validity criteria. However, at the population level, 72% of the items suggested that parts of the tool were not valid and required revision. The main suggestions from the experts pointed to the need to reformulate items in which the separation between science and society appeared reinforced and to develop more items about the gender perspective of a research project. The revised version of the tool should serve as a well-founded, comprehensive evaluation instrument for on-going and future projects whose goal is to self-reflect and compare participatory research processes.

Psychological Balance Scale: Validation Studies of an Integrative Measure of Well-Being

Studies infer Psychological Balance from the absence of psychopathology. In this article, we investigated this construct as an antecedent of well-being. We present empirical evidence toward the validation of a new theoretical model regarding Psychological Balance, a dynamic state with relatively constant characteristics, comprising Consistency and Flexibility and influenced by a Self/Others Ratio. A battery of 31 items, as indicators of Consistency, Flexibility, and Self/Others Ratio, aided this empirical investigation. In an online study (N = 933), we collected cross-sectional data from the United Kingdom. Results of cross-validation analyses provided evidence toward the validity of the proposed model and the psychometric properties of its instrument. There were statistically significant associations between Consistency (i.e., degree of integration of a universal value structure as self-related characteristics that motivate personal goals and behavior), Flexibility (i.e., degree of ability to re-define meaningful and important goals in response to situational challenge), and five well-being variables (e.g., Meaning in Life). Self/Others Ratio (i.e., ratio of motivation to serve self-interest and the interest of others), operationalized as a binary variable (e.g., close and away from 1), moderated some of these associations. Altogether, this work may contribute toward a nuanced understanding of well-being and form the basis of interventions that aim to decrease emotional discomfort and increase meaning, happiness, and life satisfaction.

A Computer-Based Interactive Narrative and a Serious Game for Children With Asthma: Development and Content Validity Analysis

Background

Nonadherence to medications, failure to prevent exposure to asthma triggers, lack of knowledge about using medications, and fixed mindsets contribute to poor asthma control in children. Digital learning could provide a new strategy for improving health-related outcomes in children with asthma.

Objective

The aim of this study is to develop and design a digital educational program, titled Module of Inhaler and Asthma Triggers for Children (MIRACLE), for Indonesian children with asthma. The program comprises an interactive narrative and a serious game. It was proposed to increase the understanding of asthma self-management, instruct on proper inhaler techniques, improve asthma control, and promote a growth mindset for children with asthma.

Methods

Two phases of research were conducted to develop the program. In the first phase, a literature search and two rounds of the Delphi technique were conducted to obtain agreement from an expert panel regarding elements of asthma self-management and the design of interactive narratives and a serious game. The expert panel item statements were evaluated using the content validity index (CVI). In the second phase, the SERES framework, Norma Engaging Multimedia Design, and Psychological Theory of Growth Mindset were applied to create a storyline, learn objectives, and game challenges.

Results

In the first phase, 40 experts were invited to participate in Delphi round 1. Forty responses were collected to generate 38 item statements that consisted of part 1, elements of asthma self-management (25 items), and part 2, design of an interactive narrative and a serious game (13 items); 38 experts were involved in Delphi round 2. In total, 24 statements in part 1 and 13 items in part 2 had item-CVI values >0.80. The average CVI was 0.9, which was considered acceptable. Four narrative plots and five game sessions were developed during the second phase. Challenges with the scenario, scoring, and feedback on asthma difficulties were designed to promote a growth mindset for learners.

Conclusions

We developed a culture-specific, computer-based asthma program containing an interactive narrative and a serious game to deliver asthma self-management and promote a growth mindset among Indonesian children.

Associations between Socio-Demographic Factors and Hypertension Management during the COVID-19 Pandemic: Preliminary Findings from Malaysia

The perspectives of hypertensive patients on the state of hypertension control during the ongoing pandemic restrictions have not been extensively studied in Malaysia. Therefore, this study aimed to assess the impact of socio-demographic factors, health literacy, and adherence on the overall hypertension management in a group of Malaysian hypertensive patients during the COVID-19 pandemic. An anonymous, online cross-sectional study was conducted over three months that involved a group of Malaysian adults with hypertension. A validated, self-administered 30-item questionnaire was prepared in Malay and English languages on Google Forms. The link was then distributed to participants on social media (Facebook and WhatsApp). Following survey validation, a pilot study with 30 participants who met the inclusion criteria was carried out. The total scores for health literacy, adherence, and pandemic impact on hypertension control were calculated and compared across all independent variables. In a total of 144 study participants, controlled blood pressure was reported in 77% (N = 111). There were good levels of adherence and health literacy scores but moderate levels of pandemic impact scores. The total adherence scores showed a statistically significant difference between age groups (χ² = 6.48, p = 0.039) and those who reported having controlled and uncontrolled blood pressure (U = 1116, p = 0.001). Moreover, the analysis revealed statistically significant differences in total pandemic impact scores based on the age group (χ² = 15.008, p = 0.001), household income (χ² = 6.887, p = 0.032), employment (U = 1712, p = 0.006), and marital status (U = 520.5, p < 0.001). The youngest age group (18-39) years, the lowest income group, unemployed and unmarried individuals, had significantly higher pandemic impact scores. This denotes that those individuals were more prone to be negatively affected by the pandemic regarding their hypertension management. Most participants reported relatively controlled blood pressure and good levels of health literacy as well as adherence amidst the pandemic. To a moderate extent, study participants perceived that the pandemic had a negative effect on hypertension management. The perceived negative impact of the pandemic was attributed to several socio-demographic factors, such as age, household income, employment, and marital status.