Evaluation of methods used for estimating content validity

A scale development study: Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment

INTRODUCTION

As hemodialysis is a long-term treatment method requiring significant self-management skills, it affects both the patient and the caregiver in many ways. It is inevitable that changes in the burden perceived by the caregiver over time will not affect the patient's health care outcomes. The aim of this study was to develop an up-to-date scale by examining the psychometric properties of items created specifically for the care burden perceived by individuals who provide care for patients receiving hemodialysis treatment.

METHODS

This study is a methodological study with the use of the COSMIN Checklist. The sample of the study included 404 individuals who were the primary caregivers of patients receiving hemodialysis treatment. Data were collected using descriptive characteristics form and the draft form of the Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment. Exploratory and confirmatory factor analysis and predictive validity were used to evaluate validity. The Cronbach's alpha reliability coefficient, item analysis, and test-retest method were employed to evaluate reliability.

RESULTS

According to exploratory factor analysis, a scale structure with four subdimensions was determined, and goodness of fit was achieved using confirmatory factor analysis. The Cronbach's alpha coefficient of the final form of the scale consisting of 34 items was found to be 0.95 for the total scale, 0.93 for the self-management support subscale, 0.91 for the psychological support subscale, 0.91 for the caregiver symptom subscale, and 0.93 for the caregiver individual coping subscale.

CONCLUSION

The Primary Caregiver Burden Scale Individuals Receiving Hemodialysis Treatment, which was found to meet the validity and reliability criteria, has a four-point Likert-type scoring structure, 34 items, and four subdimensions. It is thought that the scale can make significant contributions to the international literature if its validity and reliability are established with nursing practices and research.

Global Assessment of Palliative Care Need: Serious Health-Related Suffering Measurement Methodology

CONTEXT

Inequities and gaps in palliative care access are a serious impediment to health systems especially in low- and middle-income countries and the accurate measurement of need across health conditions is a critical step to understanding and addressing the issue. Serious Health-related Suffering (SHS) is a novel methodology to measure the palliative care need and was originally developed by The Lancet Commission on Global Access to Palliative Care and Pain Relief. In 2015, the first iteration - SHS 1.0 - was estimated at over 61 million people worldwide experiencing at least 6 billion days of SHS annually as a result of life-limiting and life-threatening conditions.

OBJECTIVES

In this paper, an updated methodology - SHS 2.0 - is presented building on the work of the Lancet Commission and detailing calculations, data requirements, limitations, and assumptions.

METHODS AND RESULTS

The updates to the original methodology focus on measuring the number of people who die with (decedents) or live with (non-decedents) SHS in a given year to assess the number of people in need of palliative care across health conditions and populations. Detail on the methodology for measuring the number of days of SHS that was pioneered by the Lancet Commission, is also shared, as this second measure is essential for determining the health system responses that are necessary to address palliative care need and must be a priority for future methodological work on SHS.

CONCLUSIONS

The methodology encompasses opportunities for applying SHS to future policy making assessment of future research priorities particularly in light of the dearth of data from low- and middle-income countries, and sharing of directions for future work to develop SHS 3.0.

Translation, cross-cultural adaptation, and psychometric validation of the Malay version of the Assessment of Quality of Life-6 Dimensions (Malay-AQoL-6D) instrument among Malaysians living with chronic heart failure

BACKGROUND

This study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument's acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF).

METHODS

The translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity.

RESULTS

The Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83-1.00, average CVI: 0.98), internal consistency (Cronbach's alpha: 0.72-0.89; MacDonald's omega: 0.82-0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79-0.95). Confirmatory factor analysis confirmed the instrument's two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value < 0.001; root mean square error of approximation [RMSEA]: 0.051; comparative fix index [CFI]: 0.945, Tucker-Lewis index [TLI]: 0.937; standardised root mean-squared error [SRMR]: 0.058). The Malay-AQoL-6D's concurrent validity was evident through its good agreement with EQ-5D-5L. Multiple hypothesis tests further affirmed its construct and known-group validity. The Malay-AQoL-6D's psychometric properties remained consistent across different missing data techniques.

CONCLUSION

The findings suggest that Malay-AQoL-6D could be a culturally acceptable, reliable, and valid HRQoL measure for quantifying HRQoL among the local HF population. Future studies are necessary to further validate the instrument against other measures and confirm the instrument's test-retest reliability and responsiveness, which are possible with the availability of the Malay-AQoL-6D.

Developing and validating the Nepalese Abuse Assessment Screen (N-AAS) for identifying domestic violence among pregnant women in Nepal

This study culturally adapted and validated a Nepalese version of the Abuse Assessment Screen (AAS) tool for identifying domestic violence among pregnant women in Nepal, creating the Nepalese Abuse Assessment Screen (N-AAS). International and national topic experts reviewed the initial N-AAS version using the Delphi method, and pregnant women participated in cognitive interviews, providing feedback on the N-AAS as user experts. Subsequent pre-testing of a comprehensive questionnaire, which included the translated version of the N-AAS, occurred in two tertiary care hospitals using an electronic format known as Color-Coded Audio Computer-Assisted Self-Interview (C-ACASI). The study assessed the content validity index, compared the concurrent validity of the N-AAS with the gold standard interview, estimated the prevalence of domestic violence from two hospitals, and calculated the Kappa coefficient. The reliability of the entire questionnaire was also evaluated through a test-retest analysis, with content validity rated as "good to excellent" by topic and user experts and high test-retest reliability (91.2-98.9%), indicating consistency across questionnaires completed at two different time points, with 12% of participants reporting any form of violence. The N-AAS demonstrated ≥91.7% specificity for all forms of abuse, accurately identifying non-abuse cases. In addition, moderate to excellent sensitivity was observed for emotional abuse (52.5%) and physical abuse since marriage (50%), while sensitivity for physical abuse in the past 12 months was 100%. Thus, the N-AAS demonstrated reliable test-retest results with a good Kappa coefficient and specificity, as well as showing excellent sensitivity for detecting recent physical abuse and moderate sensitivity for detecting emotional abuse and physical abuse since marriage. Because cultural context often leads women to normalize and tolerate abuse from spouses and family members and women are thus reluctant to report abuse, the results imply that the N-AAS can serve as a valuable screening tool for domestic abuse in antenatal care settings in Nepal.

Validation of an instrument for patient classification to support obstetric nursing care

OBJECTIVES

to develop and validate an instrument for the classification of pregnant and postpartum women according to the demand for nursing care.

METHODS

a methodological study conducted in three stages: 1) construction of the instrument based on literature review; 2) content validation using the Delphi technique with 12 experts; and 3) Evaluation of the convergent construct validity through the correlation between the scores of the constructed instrument and the Fugulin instrument.

RESULTS

an instrument with ten indicators of specific care for pregnant and postpartum women was developed. A content validity index higher than 0.9 was obtained, requiring only one round of the Delphi technique. The Spearman coefficient was 0.64 between the instruments, indicating a strong correlation.

CONCLUSIONS

the classification instrument specifically constructed for pregnant and postpartum women showed evidence of content validity and convergent construct validity with a widely used instrument in the national territory.

Development and Validation of a Tool to Explore Attitudes Towards meDication adHErence Using a Novel Self-Reported QuestionnairE (ADHERE-7)

Despite the availability of various tools for measuring medication adherence, efficiently identifying non-adherence levels and reasons at the point of care remains challenging. Existing tools often lack the ease of use needed for practical clinical application. This study aimed to develop and validate a user-friendly tool to provide healthcare professionals with a concise yet comprehensive means of identifying adherence behaviors. The methodology consisted of two phases: tool items were first developed using the nominal group technique with healthcare professionals, followed by a cross-sectional pilot study involving community-dwelling adults in Croatia. Validation analysis indicated acceptable face and content validity and satisfactory criterion validity, with Attitudes towards meDication adHErence self-Reported questionnairE (ADHERE-7) scores correlating with both the self-reported five-item Medication Adherence Report Scale (MARS-5 tool) (ρ = 0.765; p < 0.001) and an objective measure of the proportion of days covered (PDC) from pharmacy prescription claims data (G = 0.586; p = 0.015). Construct validity revealed three factors: Aversion, Comfort, and Practical Non-Adherence, with Cronbach's alpha values of 0.617 for Aversion and 0.714 for Comfort Non-Adherence. The mean total score for ADHERE-7 was 26.27 ± 2.41 (range 17 to 28). This robust validation process confirms the ADHERE-7 tool as a reliable instrument for assessing medication adherence, addressing aversion, comfort, practical issues, and both intentional and unintentional nonadherence.

Turkish version of the resilience scale for young children: Validity and reliability study

PURPOSE

This study was conducted to determine the validity and reliability of the Turkish version of the Resilience Scale for Young Children.

METHOD

This study used a methodological and descriptive design. The study was conducted with 210 parents of children aged 2-6 years at a Family Health Centre in Sakarya from June 2023 to January 2024. Data was collected by face-to-face interviews via a Descriptive Information Form and the Chinese Resilience Scale for Young Children. Translation processes, expert opinions, and content validity were meticulously addressed. Data analysis was utilized by IBM SPSS Statistics and AMOS 24.

RESULT

The mean age of parents was 35.85 ± 6.52 years, and 82.9% of the parents were mothers (n = 174). The item-content validity index (I-CVI) ranged between 0.81 and 0.94, indicating a high level of agreement between the experts. The Cronbach's alpha value for the scale was 0.791. In the exploratory factor analysis, it was determined that the distribution of the items according to the sub-dimensions was consistent with the original scale. Confirmatory factor analysis results are as follows: chi-square/df = 2.395, RMSEA = 0.082, GFI = 0.842, CFI = 0.853, IFI = 0.856, RFI = 0.726, NFI = 0.776 and TLI = 0.820.

CONCLUSION

This study revealed that the Turkish scale with four sub-dimensions and 16 items is a valid and reliable tool.

PRACTICE IMPLICATIONS

It is recommended to use the Turkish version of the Resilience Scale for Young Children to assess resilience in children aged 2-6 years.

Relationship among group learning, individuals' and groups' internalization of evidence-based practice, and nurses' sustainment of the practice: a cross-sectional study

PURPOSE

This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP.

DESIGN/METHODOLOGY/APPROACH

Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted.

FINDINGS

Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed.

ORIGINALITY/VALUE

In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.

Role of the health literacy assessment in healthcare: Content validation of "Health Literacy Behaviour" nursing outcome

PURPOSE

To validate the content of the "Health Literacy Behaviour" nursing outcome (NO).

METHODS

A content validation study was conducted during 2022. Each indicator was included in the NO, and its response levels were operationally defined. The initial version of each indicator and its response levels were refined and validated through the Delphi method. A panel of health literacy (HL) and nursing taxonomies experts evaluated the content through two content validity indicators. The content validity of the NO and each index was determined by calculating the content validity index (CVI). A qualitative analysis of the recommendations provided by the experts was carried out to improve the understanding of the indicators and their levels.

FINDINGS

A total of 108 experts participated in this study. Mostly females with more than 10 years of professional experience. The results demonstrated a high CVI of the indicators and the NO "Health Literacy Behaviour." All indicators achieved excellent (CVI ≥ 0.80) relevance and clarity. The CVI universal average method (CVI-p) of the NO achieved an excellent result of 0.90.

CONCLUSIONS

The indicators included in the NO "Health Literacy Behaviour" have content validity.

IMPLICATIONS FOR NURSING PRACTICE

These findings provide evidence-based indicators to measure the patient's actions to obtain, process, and understand information about health and disease, interact with the health system, and make informed health decisions. The validation of this NO would identify populations with low HL, allowing the health of this community to be promoted. Health literacy should be a priority objective of health management and policies.

Anxiety Inventory for Respiratory Disease: Cross-Cultural Adaptation and Semantic Validity of the Brazilian Version for Individuals with Chronic Obstructive Pulmonary Disease

Background

Most instruments available to screen for anxiety in people with chronic obstructive pulmonary disease (COPD) are not disease specific. Therefore, the Anxiety Inventory for Respiratory Disease (AIR) was developed to measure anxiety for this patient group; however, it requires cross-cultural adaptation for use in non-English speaking countries.

Purpose

To carry out cross-cultural adaptation of the AIR scale for Brazilian patients with COPD and to analyze its semantic validity.

Patients and Methods

This methodological study followed six stages: 1) Initial translation by two independent translators fluent in English; 2) Synthesis of translations; 3) Back translation by two English first language translators; 4) Expert committee review (eight healthcare professionals, a methodologist, the translators, and back-translators); 5) Pre-final version evaluation with 30 patients with COPD through a cognitive interview; and 6) Submission of documents. Semantic validity was analyzed by agreement rate and content validity index (CVI) for the committee equivalence assessments.

Results

1) Initial translation: the two translated versions presented eight divergences; 2) Synthesis of translations: the differences were discussed to reach consensus; 3) Back-translation: there were no important inconsistencies; 4) Expert Committee: the experts proposed eight and the instrument developer proposed three changes, which were analyzed and voted on, resulting in the pre-final version; 5) Evaluation of the pre-final version: data collection allowed for other changes and the formulation of instructions by applying the adapted instrument in an interview format. Patients rated the questions as clear or very clear; 6) The expert committee and the developer approved the final documents. The agreement rate and CVI were ≥ 0.80 for all items of the scale final version.

Conclusion

The process of cross-cultural adaptation followed all necessary stages and the semantic validity results were adequate, providing the Brazilian version of the AIR to assess anxiety symptoms in patients with COPD.

Development and validation of measures of pharmacists' acceptability and willingness to screen for perinatal depression

BACKGROUND

While pharmacists' roles in mental healthcare are expanding, research exploring pharmacists' acceptability and willingness to provide mental health services is limited. This study developed and validated theory-driven measures of pharmacists' acceptability and willingness to screen for perinatal depression in community pharmacy settings.

MATERIALS/METHODS

Items were developed using published literature and the Theoretical Framework of Acceptability (TFA), then content validated using consensus methods with experts who completed the content validity index (CVI). The revised items were disseminated to pharmacists in Australia. Responses were analysed descriptively. Exploratory factor analyses (EFA) were used to explore the factorial structure and generate scales. Multivariate regression analysis was conducted to explore predictors of willingness.

RESULTS

A 58-item questionnaire was developed, encompassing the 7 domains of the TFA and an eighth domain (willingness). The average CVI was 0.92, domain range (0.88-0.96). The universal CVI was 56/58. Expert feedback informed item revision, creation and deletion. Pharmacists' responses (n = 157) to the final 42-item questionnaire indicated overall acceptance and willingness to conduct PND screening. However, perceived knowledge was lacking. The EFA resulted a two-factor solution (1 = acceptance; 2 = self-efficacy). The measurement scales created had good internal consistency. In multivariate regression analysis, 'Acceptance' (Beta = 0.949 (0.760-1.103)) and 'Self-Efficacy' (Beta = 0.107 (0.036-0.174)) were significant predictors of 'Willingness' and the model predicted 77 % of the variation in 'Willingness'.

CONCLUSIONS

Psychometrically-sound measures of pharmacists' acceptability and willingness to screen for PND have been developed with stakeholder input. The questionnaire can be used for standardised measurement of these constructs across studies.

A hybrid systematic narrative review of instruments measuring home-based care nurses' competency

AIM

The aim of the study was to identify and synthesize the contents and the psychometric properties of the existing instruments measuring home-based care (HBC) nurses' competencies.

DESIGN

A hybrid systematic narrative review was performed.

REVIEW METHODS

The eligible studies were reviewed to identify the competencies measured by the instruments for HBC nurses. The psychometric properties of instruments in development and psychometric testing design studies were also examined. The methodological quality of the studies was evaluated using the Medical Education Research Study Quality Instrument and COSMIN checklist accordingly.

DATA SOURCES

Relevant studies were searched on CINAHL, MEDLINE (via PubMed), EMBASE, PsychINFO and Scopus from 2000 to 2022. The search was limited to full-text items in the English language.

RESULTS

A total of 23 studies reporting 24 instruments were included. 12 instruments were adopted or modified by the studies while the other 12 were developed and psychometrically tested by the studies. None of the instruments encompassed all of the 10 home-based nursing care competencies identified in an earlier study. The two most frequently measured competencies were the management of health conditions, and critical thinking and problem-solving skills, while the two least measured competencies were quality and safety, and technological literacy. The content and structural validity of most instruments were inadequate since the adopted instruments were not initially designed or tested among HBC nurses.

CONCLUSION

This review provides a consolidation of existing instruments that were used to assess HBC nurses' competencies. The instruments were generally not comprehensive, and the content and structural validity were limited. Nonetheless, the domains, items and approaches to instrument development could be adopted to develop and test a comprehensive competency instrument for home-based nursing care practice in the future.

IMPACT

This review consolidated instruments used to measure home-based care nurses' competency. The instruments were often designed for ward-based care nurses hence a comprehensive and validated home-based nursing care competency instrument is needed. Nurses, researchers and nursing leaders could consider the competency instruments identified in this review to measure nurses' competencies, while a home-based nursing care competency scale is being developed.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was required in this review.

A single centre service evaluation of patients' experiences participating in radiotherapy clinical trials during and post COVID-19 in Northern Ireland, UK

INTRODUCTION

Radiotherapy (RT) clinical trials allow patients to access cutting-edge innovative cancer treatments. Clinical Research Therapy Radiographers (CRRs) play an important role in the management and care of RT trial patients. The COVID-19 pandemic caused major disruption to RT trial delivery. Measures to mitigate COVID-19 risk continue to have an effect on patient contact and communication within cancer centres in the United Kingdom (UK). This study aimed to explore patient perspectives regarding their recent RT trial experience in Northern Ireland (NI), UK.

METHODS

A single centre service evaluation was conducted in NI. Patients who were recruited into a RT clinical trial from January 2020 to January 2023 were invited to participate. Surveys were posted to 50 participants in April 2023. Quantitative and qualitative data was captured and analysed using descriptive statistics and Braun and Clarke's six-step thematic analysis framework respectively. Ethical approval was obtained through Ulster University and the NHS Trust.

RESULTS

Forty-three of the 50 invited participants responded (86%). Forty-two respondents (79%) had a prostate cancer diagnosis. Forty-one (98%) participants indicated that CRRs were always approachable, polite and courteous and would recommend taking part in a RT trial to friends and family. Identified areas for improvement included aspects regarding consent and participant decision-making.

CONCLUSION

This study suggests that despite the implemented measures to suspend research and mitigate COVID-19 risk, patients remained highly satisfied with the quality of care that they received through their participation in RT trials.

IMPLICATIONS FOR PRACTICE

The results of this service evaluation will facilitate maintenance and improvement of patient focused delivery of cancer trials within the host centre. This study builds on evidence highlighting the importance of the CRR role and role development for radiographers.

Development and validation of a questionnaire on perceived prosthodontic treatment needs in Malaysian adults

STATEMENT OF PROBLEM

A discrepancy between dentists' assessments and patients' expectations during prosthodontic treatment is inevitable. Incorporating dental patients' concerns about their prosthodontic treatment needs is essential during treatment planning, yet studies assessing these needs in adult dental patients are lacking.

PURPOSE

The purpose of this study was to develop and validate a novel instrument, termed the questionnaire on perceived prosthodontic treatment needs (PPTN), that assesses perceived prosthodontic treatment needs in adults.

MATERIAL AND METHODS

The PPTN was developed following a literature review, consultation with healthcare workers, and patient interviews. It included 15 questions and a self-rated need for prosthodontic treatment, categorized on a Likert scale. A cross-sectional descriptive study was completed on 193 dental patients seeking or receiving prosthodontic treatment.

RESULTS

Three perceived prosthodontic treatment need factors were identified (psychosocial impact, esthetic concern, and function) by using exploratory factor analysis. A higher PPTN score indicated greater perceived prosthodontic treatment needs. The identified factors represent 67.8% of the variance with eigenvalues of >1. The PPTN had a high degree of internal consistency and reliability, as the final questionnaire received a Cronbach alpha of 0.75 and an intraclass coefficient of 0.75 with a 95% confidence interval of 0.68 to 0.80 (F(192, 576)=3.94, P<.001).

CONCLUSIONS

The newly developed questionnaire was valid and will help understand patients' perceived treatment needs and benefit further prosthodontic research and clinical application.

Turkish validity and reliability study of the adolescent asthma self-efficacy questionnaire

PURPOSE

The purpose of this study was to determine the validity and reliability of the Adolescent Asthma Self-Efficacy Questionnaire for the Turkish population.

DESIGN AND METHOD

This study involved 198 adolescents aged 12-18 who had been diagnosed with asthma. Data were collected using the Sociodemographic Information Questionnaire and the Turkish version of the Adolescent Asthma Self-Efficacy Questionnaire. The validity of the scale was evaluated using the content validity index, explanatory and confirmatory factor analyses, Cronbach's alpha reliability score, split-half method, item-total score correlation, and test-retest.

RESULTS

The Turkish version of the Adolescent Asthma Self-Efficacy Questionnaire has a total explained variance of 63%. Factor loadings were found to be higher than 0.40 in both explanatory and confirmatory factor analyses. The test-retest reliability coefficient is 0.91, and the total Cronbach's alpha value of the scale is 0.93, with all subscales having a Cronbach's alpha value >0.84. The model fit indices of the scale were found to be at an acceptable level.

CONCLUSION

The Adolescent Asthma Self-Efficacy Questionnaire is a valid and reliable measurement tool for the Turkish population.

PRACTICE IMPLICATIONS

The AASEQ can be a useful tool for healthcare professionals in the assessment of self-efficacy in adolescents who have had a diagnosis of asthma.

Development and content validation of an NOC-based instrument for measuring knowledge and self-care behaviors in hypertensive disorders of pregnancy: CoNOCiTHE

PURPOSE

The aim of this study is to design and validate the content of an instrument based on the Nursing Outcomes Classification (NOC) "Knowledge: disease process" and "Risk control: hypertension" to measure pregnant women's knowledge and self-care behaviors about hypertensive disorders.

METHODS

The study was carried out in three phases: (a) content validity of the indicators, (b) construction, and (c) content validity of the instrument.

FINDINGS

The instrument contains 72 items with an average content validity ratio and representativeness of 0.92. The items that did not reach the established values were eliminated or reformulated according to the observations made by the experts.

CONCLUSIONS

This study provides the first instrument for perinatal maternal care designed from the NOC that has demonstrated adequate content validity and representativeness of the NOCs on which it is based. The next phase in the development of the instrument is to test its validity and reliability.

IMPLICATIONS FOR NURSING PRACTICE

CoNOCiTHE is a tool that can be useful in assessing pregnant women's knowledge and self-care behaviors about hypertensive disorders, contributing to the documentation and quality of maternal perinatal nursing care.

[Synthetic indicator of compliance with standards for Quality Units of health centers and multicenter prospective pilot study]

BACKGROUND AND OBJECTIVE

In Spain, Quality Units play a key and unique role in advising healthcare centers on the methodology of healthcare quality. The objectives of the study were to develop computer algorithms to obtain a synthetic indicator of standard compliance for Quality Units and to pilot its functioning in these units.

MATERIALS AND METHODS

The Excel program was used to establish evaluation algorithms, and quantitatively interrelate and weight various categories of standards, as a computer evaluation tool, to build a continuous improvement cycle system, and offer a global synthetic indicator of compliance. The tool was tested in a prospective multicenter pilot study, in which coordinators of Quality Units from different health centers and care settings participated, to evaluate the usefulness of the tool and compliance with the standards, in addition to analyzing the content validity of each standard.

RESULTS

The formulas for the structured computer algorithms were developed, consecutively, in a «PLAN-DO-CHECK-ACT» improvement cycle for the 9 categories of standards, resulting in a single synthetic indicator of compliance. Twenty-one Quality Units participated in the piloting. The overall average compliance rate for the synthetic indicator was 55.63% with differences between centers (P=.002) and between categories (P<.0001), but not by autonomous communities (P=.86) or by areas (P=.97). Content validity was ensured through the variable of «understanding» of the standards (P<.001), and through their «justification» with documentary evidence (P<.001).

CONCLUSIONS

The computer tool with the synthetic indicator have allowed for the evaluation of standard compliance in Quality Units of healthcare centers.

Assessing reliability and validity of food safety culture assessment tools

Since its recognition as a plausible direction to assure food safety, food safety culture research has evolved with several commercial and scientific assessment tools developed to evaluate the food safety culture in food businesses. However, existing research does not specify the validity and reliability checks required to demonstrate rigor in the tool development process and there is no unified methodology to confirm robustness of the tools to ensure trustworthiness and usefulness of findings and inferences generated. The purpose of the study was to develop a method to evaluate food safety culture assessment tools and to assess the reliability and validity of existing food safety culture assessment tools using the developed method. Eleven elements were found to be key in validating food safety culture assessment tools. Of the eight tools assessed, only one tool (CT2) was validated on each of the elements. The depth of validation strategies differed for each tool. Three out of the five commercial tools published peer reviewed publications that demonstrated the validation checks that were done. Face validation, and pilot testing were evident and appeared to be done the most. Whilst content, ecological, and cultural validity were the least validated for scientific tools, factor analysis and reliability checks were the least evaluated for commercial tools. None of the tools were assessed for postdictive validity, concurrent validity and the correlation coefficient relating to construct validity. Having an established science-based approach is key as it provides a way to determine the trustworthiness of established assessment tools against accepted methods.

Evidence of content validity of the nursing outcome "sexual functioning" from the nursing outcome classification

PURPOSE

To evaluate the content validity evidence of the nursing outcome "sexual functioning" from the Nursing Outcomes Classification (NOC).

METHODS

A multi-method study, including a methodological study analyzing the content validity evidence of the NOC outcome and sexual functioning, and a quantitative, descriptive, cross-sectional study. In the first phase, a literature review was conducted to map and identify clinical indicators associated with sexual functioning to construct the conceptual (CD) and operational definitions (ODs) of each outcome indicator. In the second phase, experts assessed the CD and OD for clarity, theoretical relevance, and theoretical pertinence. The critical validity ratio (CVR) was calculated for each indicator. In the third phase, a pilot test of sexual functioning measurement was conducted with 33 patients hospitalized for coronary artery disease. Internal consistency was calculated through Cronbach's alpha.

RESULTS

The CD and OD were constructed based on 120 articles and analyzed by 13 experts; four rounds were required to achieve the critical CVR in each phase. In the pilot test, the nursing outcome achieved a Cronbach's alpha of 0.95, and the mean assessment time was 26 min. Indicators with the highest mean scores were related to knowledge of personal needs and capabilities and comfort with one's own body.

CONCLUSION

The CD and OD developed for the NOC outcome, sexual functioning, had adequate evidence of content validity. The outcome content has high internal consistency. Further studies on the validity of the nursing outcome should be conducted to increase its validity.

IMPLICATIONS FOR PRACTICE

The nursing outcome, sexual functioning, can be a tool used by nurses to evaluate the effect of nursing education and interventions on sexual functioning in the adult population.

Translation and adaptation of the person-centered maternity care scale to a Persian-speaking population: a confirmatory factor analysis

BACKGROUND

Recognized as the most exhaustive multidimensional evaluation of women's person-centered experiences during childbirth, the Person-Centered Maternity Care (PCMC) Scale offers domain-specific insights into facets of care. This instrument has yet to be translated into Persian. Hence, this study purposed to translate and ascertain the reliability and validity of a Persian version of the PCMC scale for postpartum women in Iran.

METHODS

A cross-sectional study was facilitated at multiple comprehensive health centers within Tehran, Iran, from February 2022 until July 2022. Postpartum women within seven days after childbirth who were referred to selected comprehensive health centers for newborn thyroid screening were conveniently sampled. The validation process for the questionnaire utilized confirmatory factor analysis (CFA), while it gauged convergent validity via factor loads, average variance extracted (AVE), along with composite reliability (CR). Discriminant credibility was evaluated utilizing HTMT alongside the Fornell-Larcker Criteria. Data analysis procedures were conducted through IBM SPSS Statistics for Windows Version 16 and SMART PLS Statistics for Windows Version 4.0.9.9.

RESULTS

All the items were within the acceptable range of factor loading, except for questions 3 of the facility and 6 of dignity, which were removed from the model. The AVE values for all the variables were above 0.50, and the CR values were above 0.78, indicating convergent validity. On the horizontal loading table, all of the indicators met the conditions. Additionally, the findings validate that the HTMT indicator associated with all constructs remained below 0.9, which confirms divergent relevance about the survey tool under consideration. The composite reliability values also indicated good overall reliability for all the constructs, ranging from 0.78 to 0.91.

CONCLUSIONS

The results of the present study indicate that the Persian version of the PCMC is a reliable and valid tool for measuring person-centered maternity care in Persian-speaking populations.

The effect of mobile marketing antecedents on the purchase intention of staple products: A case of the bottom of the pyramid (BoP) market segment in Khayelitsha, South Africa

Purpose

This research seeks to ascertain the impact of mobile marketing antecedents on the purchase intention of staple products among BoP consumers to create a viable digital-commerce channel that serves this segment. To achieve this, the paper proposes that mobile marketing antecedents, such as service quality and price sensitivity, influence trust and satisfaction, which, in turn, influence the purchase intention of staple products.

Design/methodology/approach

A questionnaire was collected from 385 BoP consumers. Smart PLS 4 was used to analyse data using Structural equation modelling (SEM).

Findings

Service quality positively influences trust towards mobile marketing. In contrast, a similar positive trend was observed for satisfaction, price sensitivity, service quality, and purchase intentions. Surprisingly, satisfaction and trust did not influence purchase intentions.

Originality/value

Through the Value-Based Adoption Model (VAM), original contributions to the literature have been established, which have received little attention from consumer behaviour researchers, particularly in the context of emerging economies, to explore several mobile marketing antecedents that motivate or demotivate BoP consumers, who are mainly untapped, to make online purchases.

Development and psychometric analysis of care needs scale for mothers of children with congenital heart disease

PURPOSE

This cross-sectional study aimed to create and evaluate a care needs scale for mothers of children with congenital heart disease (CHD) to determine its psychometric properties.

DESIGN AND METHODS

This methodological research was conducted with 155 mothers whose children were diagnosed with CHD and were treated at a university hospital. The study's methodology included scale development, specialist opinions, and a pilot test. Data analysis involved descriptive statistics, exploratory and confirmatory factor analyses, and reliability assessments.

RESULTS

The 11-item scale was created using component analysis, expert comments, and pilot testing. It was divided into two categories: Information Needs Regarding Disease and Treatment and Needs Regarding Care. The Exploratory Factor Analysis revealed a 2-factor structure, explaining 41.5% of the variance. Reliability analysis showed reliable dimensions, and Tukey's scalability test indicated the scale requires separate dimension evaluation. The model fit indices were obtained as CMIN/DF (72.751/41) = 1.774, GFI = 0.925, IFI = 0.923, TLI = 0.893, CFI = 0.920, RMSEA = 0.071, SRMR = 0.063. The Cronbach's alpha coefficient for subdimension 1 was 0.758, and for subdimension 2 was 0.678, indicating reliable dimensions.

CONCLUSION

The developed scale provides a valuable tool for assessing the care needs of mothers of children with CHD, contributing to enhancing maternal support programs in pediatric cardiology clinics.

PRACTICE IMPLICATIONS

Assessment of the care needs of mothers who have children with CHD is promising for the development of educational programs on this subject and to ensure the competence of mothers for care.

Transition of care in a Danish context: translation, cross-cultural adaptation and content validation of CTM-15 and PACT-M

BACKGROUND

Transition of care from hospitalisation to home is a complex process with potential patient safety risks, especially for patients with multimorbidity. Traditionally, the quality of transition of care has been evaluated primarily through readmission rates. However, interpreting the readmission rates presents challenges, and readmission rates fail to capture the patient's perspective on the quality of the care transition. Insight into the patient's experience with their care or a health service can be provided through the use of patient-reported experience measures (PREMs), and the two PREMs Care Transitions Measure 15 (CTM-15) and Partners at Care Transitions Measure part 1 and 2 (PACT-M1 and PACT-M2) assess on the quality of transition of care from the patients' perspective. The aim of this study was to translate, culturally adapt, and assess content validity of CTM-15, PACT-M1, and PACT-M2 for Danish-speaking patients with multimorbidity.

METHODS

A two-step approach was used for content validation, involving cognitive debriefing and interviews with patients, representing the target group, as well as quantitative data collection from healthcare professionals representing all three sectors of the Danish healthcare system. The patients were systematically interviewed regarding the aspects of content validity; comprehensibility, relevance, and comprehensiveness. The healthcare professionals assessed the relevance and comprehensiveness of each item through questionnaires, allowing the calculation of a content validity index (CVI). An item CVI ≥ 0.78 is considered good.

RESULTS

The results of the qualitative data indicated that both CTM-15 and the PACT-M questionnaires were considered relevant, and comprehensible, and comprehensive to the target group. The CVI computed at item level determined that PACT-M1 and PACT-M2 demonstrated excellent content validity among the healthcare professionals, whereas the CVI for two items of the CTM-15 fell below the threshold value for "good".

CONCLUSION

The Danish versions of the PACT-M questionnaires demonstrated good content validity, and the CTM-15 demonstrated acceptable content validity based on qualitative data from patients and quantitative data from healthcare professionals. Further validation of the questionnaires, by assessing their construct validity and reliability is recommended.

Pharmaceutical public health competencies for Thai pharmacists: A scoping review with expert consultation

Background

Thai pharmacists' roles have increasingly shifted to a system-focused role in providing public health services. A competency framework in this area is essential to workforce development.

Objective

This study aimed to summarize and synthesize the literature on pharmaceutical public health competencies of Thai pharmacists.

Methods

The Scopus, MEDLINE, and Web of Science (Clarivate) databases were searched. The search criteria included "public health", "health promotion", "primary care", "community pharmacy", "pharmacy" and "pharmacist". Documents published in English and Thai between January 2011 and December 2020 were also examined. Unpublished documents were included. A 3-step inductive coding technique was used to develop the competency framework. To validate the findings, a 2-round, modified Delphi method was employed with 20 Thai pharmaceutical specialists between August 2022 and January 2023. The Scale-level Content Validity Index (S-CVI) was used to assess validity.

Results

The database search yielded 1429 articles. Fifty-seven articles were selected. The analysis identified 5 competency domains. The domains, along with their related competency elements and behavioral statements, were provided for expert assessment. The S-CVI scores in the first and second rounds were 0.78 and 0.93, respectively. The terminology and categories of competencies have been improved. This outcome resulted in a pharmaceutical public health competency framework for Thai pharmacists. The framework consists of 5 competency domains: 1) individual and family health promotion (3 competency elements with 10 behavioral statements), 2) community empowerment for well-being communities (6 competency elements with 23 behavioral statements), 3) information management and evidence-based practice (3 competency elements with 10 behavioral statements), 4) communication for health promotion (3 competency elements with 6 behavioral statements), and 5) pharmacoepidemiology and support for public health emergencies and epidemics (2 competency elements with 5 behavioral statements).

Conclusion

Pharmaceutical public health competencies for Thai pharmacists were developed through extensive literature review and expert consultation.

Psychometric Properties of the Principal Instructional Leadership Scale (PILS) in Saudi Arabia

BACKGROUNDS

The principal instructional leadership describes how school principals oversee the curriculum, instruction, and assessment. The main aims of the current study were translation and evaluation of the psychometric properties of the Principal Instructional Leadership Scale (PILS) in a Saudi Arabian population.

METHODS

The translation and cross-cultural adaptation process has been conducted in five stages, including forward translation, translation synthesis, backward translation, expert committee, and pilot testing. Face, content, construct, and convergent validity were used to establish validity. Cronbach's alpha coefficient and McDonald's omega (Ω) were used for internal consistency.

RESULTS

To validate the PILS structure, the total sample (N = 724) was randomly split into two subgroups, each comprising 362 individuals, for Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA). Five factors obtained from EFA explain 71.07 % of the variance in PILS. The PILS encompasses domains of improving curriculum quality, teaching, and enhancing the effectiveness of adaptive learning, adding to the dimensions covered by previous instructional leadership measures. The five components show strong internal consistency (0.93 to 0.97). Both first-order and second-order CFAs confirmed the 5-factor model, meeting criteria (CFI > 0.91, GFI > 0.9, IFI > 0.9, RMSEA<0.05). All 21 items displayed suitable internal consistency (Cronbach's α > 0.8, McDonald's omega >0.7). Second-order average variance extracted validity (0.50) indicated PILS validity. Gender invariance analysis revealed no significant differences (∆CFI < 0.01, ΔRMSEA<0.01) in PILS structure between genders.

CONCLUSION

The reliability and validity of the Arabic rendition of PILS are commendable, making it suitable for evaluating principal instructional leadership in Saudi Arabia.

Development and psychometric testing of the lymphedema self-management support scale for breast cancer survivors

Objective

Effective self-management support should be tailored to the individual. To provide personalized and targeted self-management support, a rigorous assessment tool is needed to screen the actual degree of lymphedema self-management support received by breast cancer survivors. This study aims to develop and psychometrically test the Lymphedema Self-Management Support Scale for Breast Cancer Survivors (LSMS-BCs).

Methods

This study involves two phases: scale development and psychometric testing. In the scale development phase, preliminary items and domains were identified through a qualitative meta-synthesis, a quantitative systematic review, and reference to previous similar scales. Expert consultation and pilot study were conducted to refine the scale and evaluate the content validity. The psychometric characteristics were tested with 447 participants using item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability assessments, as well as measurement invariance.

Results

A preliminary 21-item scale with four domains, basic management support, management support for limb volume reduction, role management support, and emotional management support, was constructed in the scale development phase and well supported by EFA and CFA. The scale-level content validity index was 0.983. Cronbach's α coefficient for overall scale and subscales ranged from 0.732 to 0.949. McDonald's ω ranged from 0.848 to 0.955. Excellent known-groups validity, concurrent validity, predictive validity, and measurement invariance were demonstrated.

Conclusions

The LSMS-BCs is psychometrically valid and reliable. It can serve as a valuable tool for assessing and understanding the lymphedema self-management support received by breast cancer survivors.

Restorative Parental Discipline and Types of Defending Bystander Intervention in Cyberbullying: The Mediate Role of Justice Sensitivity

Parental socialization strategies are critical in explaining adolescents' online behavior. This study examined the relationships between parental restorative discipline, observed justice sensitivity, and cyber-bystander defender intervention (constructive and aggressive) in cyberbullying. The sample comprised 900 Mexican adolescents (40.2% male and 58.8% female), of which 450 were from secondary school (M age = 13.6, SD = 0.8) and 450 were from high school (M age = 15.4, SD = 1.3). Structural equation modeling with latent variables was performed. Overall, the results indicate that parental restorative discipline positively relates to the observer's justice sensitivity and the adoption of constructive interventions by cyber-bystander defenders. However, restorative discipline had no significant direct relationship with aggressive intervention. Observers' justice sensitivity mediates the association between restorative parenting discipline and aggressive or constructive defender interventions. Gender does not moderate the relationship proposed in the structural model. These findings suggest that parental restorative discipline explains constructive and aggressive cyber-bystander defender interventions in cyberbullying.

The Validity and Reliability of the Thanatophobia Scale-Turkish Form: A Psychometric Study Among Nurses

Purpose: To examine the validity and reliability of the Thanatophobia Scale-Turkish Form among nurses. Design and methods: This methodological study included 154 nurses. Content and construct validity, item analysis, confirmatory factor analysis, and internal consistency were used to evaluate the data. Findings: The content validity index of the scale was 0.91. Item-total score correlation values varied between 0.453 and 0.718. As a result of the confirmatory factor analyses, one factor was confirmed. Cronbach's alpha internal consistency coefficient was 0.854. Practice Implications: Thanatophobia Scale-Turkish Form is a valid and reliable tool used to evaluate the fear of death among nurses.

Preimplementation of Critical Care Early Mobility Clinical Decision Support: A Content Validation Study

Early mobility is a form of critical care rehabilitation ranging from in-bed exercise to ambulation and is known to limit post-intensive-care functional decline. Multiple barriers prevent widespread early mobility implementation. Clinical decision support systems can optimize the decision-making process and overcome barriers to care. However, critical care early mobility clinical decision support does not exist. Our objective was to develop and establish the content validation of the operational definitions for a novel critical care early mobility assessment instrument. Content validation was conducted in two steps: (1) development of operational definitions by the research team and (2) content validation with 10 nurse experts. Quality assessment and suitability of the operational definitions for 30 items, across four safety domains, were assessed using a 7 point-Likert scale. Item content validity index scores ranged from 0.6 to 0.1 after the first validation round. Domains containing items with item content validity index scores less than the lower limit of 0.78 were modified for clarity of language. Item content validity index scores ranged from 0.8 to 1.0, and the scale-level content validity index was 0.93 after the second content validation round. Excellent content validity of the operational definitions was achieved. This is the first methodological step in a larger project to develop clinical decision support for critical care early mobility.

Key performance indicators for pharmaceutical services: A systematic review

Background

Key performance indicators (KPIs) are a set of indicators that improve the quality of services provided by pharmacists. They enable the monitoring and evaluation of result progress and optimize decision-making for stakeholders. Currently, there is no systematic review regarding KPIs for pharmaceutical services.

Objectives

To identify and assess the quality of KPIs developed for pharmaceutical services.

Methods

A systematic review was conducted in PubMed, Scopus, EMBASE, and LILACS from the inception of the database until February 5th, 2024. Studies that developed a set of KPIs for pharmaceutical services were included. The indicators were evaluated using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. Two independent reviewers performed the study selection, data extraction, and quality assessment.

Results

Fifteen studies were included. The studies were conducted in different regions, most of which were developed for clinical services in hospitals or ambulatory settings, and used similar domains for the development of KPIs such as medication review, patient safety, and patient counseling. Literature review combined with the Delphi technique was the method most used by the studies, with content validity by inter-rater agreement. Regarding methodological quality, most studies described information on the purpose, definition, and stakeholders' involvement in the set of KPIs. However, little information was observed on the strategy for risk adjustment, instructions for presenting and interpreting the indicator results, the detailed description of the numerator and denominator, evidence scientific, and the feasibility of the set of KPIs. Only one study achieved a high methodological quality in all domains of the AIRE tool.

Conclusion

Our findings showed the potential of KPIs to monitor and assess pharmacy practice quality. Future studies should expand KPIs for other settings, explore validity evidence of the existing KPIs, provide detailed descriptions of evidence, formulation, and usage, and test their feasibility in daily practice.

Translation, Cross-Cultural Adaptation, and Validation of Measurement Instruments: A Practical Guideline for Novice Researchers

Cross-cultural validation of self-reported measurement instruments for research is a long and complex process, which involves specific risks of bias that could affect the research process and results. Furthermore, it requires researchers to have a wide range of technical knowledge about the translation, adaptation and pre-test aspects, their purposes and options, about the different psychometric properties, and the required evidence for their assessment and knowledge about the quantitative data processing and analysis using statistical software. This article aimed: 1) identify all guidelines and recommendations for translation, cross-cultural adaptation, and validation within the healthcare sciences; 2) describe the methodological approaches established in these guidelines for conducting translation, adaptation, and cross-cultural validation; and 3) provide a practical guideline featuring various methodological options for novice researchers involved in translating, adapting, and validating measurement instruments. Forty-two guidelines on translation, adaptation, or cross-cultural validation of measurement instruments were obtained from "CINAHL with Full Text" (via EBSCO) and "MEDLINE with Full Text". A content analysis was conducted to identify the similarities and differences in the methodological approaches recommended. Bases on these similarities and differences, we proposed an eight-step guideline that includes: a) forward translation; 2) synthesis of translations; 3) back translation; 4) harmonization; 5) pre-testing; 6) field testing; 7) psychometric validation, and 8) analysis of psychometric properties. It is a practical guideline because it provides extensive and comprehensive information on the methodological approaches available to researchers. This is the first methodological literature review carried out in the healthcare sciences regarding the methodological approaches recommended by existing guidelines.

Validation of an Arabic version of the short form of the health literacy in dentistry scale: a cross-sectional study

BACKGROUND

The Arabic version of the short form of the Health Literacy in Dentistry scale (HeLD) had not yet been developed in previously published studies. This study aims to test the reliability and validity of an Arabic version of the short form of the HeLD questionnaire.

METHODS

The short version of HeLD was translated into Arabic and the psychometric properties were evaluated in a sample of 1,889 female students in their first year of secondary school. Test-retest reliability was assessed using the intra-class correlation coefficient (ICC), and internal consistency reliability was assessed using Cronbach's alpha. Content validity was investigated by creating a correlation matrix between the individual items of the HeLD-14, and criterion validity was determined using Pearson's correlation between the HeLD-14 score and an overall oral health rating. Sensitivity analysis was assessed by testing the associations of the HeLD-14 score with oral health-related behaviours and residential area.

RESULTS

The Arabic version of HeLD-14 (A-HeLD-14) had acceptable ICC (0.54) and excellent internal consistency (Cronbach's alpha: 0.92). The correlations between the items of the A-HeLD-14 varied from 0.3 to 0.9. The A-HeLD-14 showed a statistically significant correlation with the overall oral health rating (r = 0.37, p < 0.001). The median A-HeLD-14 score was significantly higher in participants who brushed their teeth frequently (51.31), visited the dentist regularly (52.00), consumed fresh fruit frequently (51) and consumed soda or energy drinks infrequently (51.00) than participants who brushed their teeth infrequently (41.50), visited the dentist irregularly (49.00), consumed fresh fruit infrequently (47) and consumed soda or energy drinks frequently (48.00).

CONCLUSION

The A-HeLD-14 instrument demonstrates sufficient validity, reliability, and sensitivity for measuring oral health literacy among the Arabic-speaking population.

The development of a serious game for laser applications in dentistry and the evaluation of dental students' satisfaction

BACKGROUND

This study aimed to design and implement a gamified application about the theoretical aspects of laser applications in dentistry and investigate students' satisfaction with their learning experience.

METHODS

An engaging educational program named Essential Skills and Knowledge in Learning Laser (ESKILLD) was developed to teach laser applications in dentistry. The program comprises two primary components: a "Tutorial and Quiz" section and a "Games" section. Final-year dental students were tasked with installing and using this application. A 29-item validated questionnaire (Cronbach's alpha = 0.97, ICC = 0.94) was used to evaluate students' perceptions of the applications' design and functionality. The influence of participants' gender and Grade Point Average (GPA) on their satisfaction levels was examined via the student t-test and Pearson's correlation, with a significance level of 0.05.

RESULTS

The study had 56 participants, of which 37 were female (66.07%), and 19 were male (33.92%). The students' average GPA was 15.16 out of 20. The mean rating for ESKILLD's design and functionality was 1.39 ± 0.47 and 1.37 ± 0.46, respectively, signifying a high satisfaction level. Female students rated the application's coherence and learning perception significantly higher than their male counterparts (p < 0.05). However, gender did not significantly influence scores on other perception aspects or overall scores. Students' GPAs and their perception scores did not have a significant correlation.

CONCLUSIONS

The results indicate that the participants were generally satisfied with the game's features and attitudes towards it, which underscores the potential effectiveness of gamification in dental courses focused on laser applications.

A Critical Review of Breastfeeding Instruments Derived From Self-Determination Theory

BACKGROUND

Understanding the motivational factors that influence breastfeeding behavior is critical for addressing suboptimal breastfeeding outcomes. Self-determination theory has been used as a framework to understand these factors.

RESEARCH AIM

The aim of this article is to identify and critically review breastfeeding instruments derived from self-determination theory and their subsequent uses in the literature.

METHOD

This critical review was guided by Grant and Booth's typological description. Eligibility criteria included full-text, peer-reviewed original instrument development and validation articles, written in the English language without limitation to specific years. Articles describing the use of the eligible instruments were also included. There were 164 articles identified initially, and four instruments were included in the final sample. Finally, five articles, including subsequent uses of the instruments were critically analyzed and an overview, assessment of validation, and analysis of subsequent use of each instrument is presented.

RESULTS

All instruments examine the degree of autonomy underlying breastfeeding motivation. The extent and quality of validation varied. Two instruments have been used in subsequent studies; one was adapted and translated into Turkish and used in three other studies, and another was used in full in one subsequent use and in part in another study. Three of four were initially developed for prenatal administration.

CONCLUSIONS

Instruments derived from self-determination theory hold promise in exploring the autonomy underlying breastfeeding motivations. Researchers who wish to use or adapt these instruments should consider the instruments' domains, validity, and administration. New measures are needed to explore other constructs from self-determination theory related to breastfeeding.

Validation of the Amharic version of perceived access to healthcare services for patients with cervical cancer in Ethiopia: A second-order confirmatory factor analysis

BACKGROUND

Accessing healthcare services is a multifaceted phenomenon involving various elements, encompassing the demand, identification, reach, and utilization of healthcare needs. The literature offers methods for capturing patients' perceptions of healthcare access. However, to accurately measure patient perceptions, it is imperative to ensure the validity and reliability of such instruments by designing and implementing localized language versions.

AIM

The primary aim of this study was to validate the Amharic version of the perceived access to health-care services among patients diagnosed with cervical cancer in Ethiopia.

METHOD

A cross-sectional study was conducted among cervical cancer patients at oncology centers in Addis Ababa, Ethiopia. A consecutive sampling approach was used and data collection took place from January 1 to March 30, 2023. Following initial validation and pretesting, a KoboCollect mobile phone application was employed for data collection. Subsequently, the collected data underwent cleaning in Microsoft Excel and analysis through Amos software v.26 and R programming. Various validity and reliability tests, such as content validity, convergent validity, face validity, divergent validity, known-group validity, and reliability tests, were executed. A second-order confirmatory factor analysis was developed to calculate incremental model fit indices, including CFI and TLI, along with absolute measures, namely SRMR and RMSEA.

RESULTS

A total of 308 participants were involved in the study, with 202 (65.6%) being patients referred from outside Addis Ababa. The initial evaluation of content validity by expert panels indicated that all criteria were met, with a CVR range of 0.5 to 1, I-CVI values ranging from 0.75 to 1, an S-CVI value of 0.91, and face validity values ranging from 2.4 to 4.8. The internal consistency of items within the final constructs varied from 0.76 to 0.93. Convergent, known-group, and most divergent validity tests fell within acceptable fit ranges. Common incremental fit measures for CFI and TLI were achieved with corresponding values of 0.95 and 0.94, respectively. The absolute fit measures of SRMR and RMSEA were 0.04 and 0.07, indicating good and moderate fit, respectively.

CONCLUSION

The study indicated a high internal consistency and validity of items with good fit to the data, suggesting potential accuracy of the domains. A five-domain structure was developed which enables adequate assessment of perceived access to health-care services of patients with cervical cancer in Ethiopia. We suggest that the tool can be utilized in other patient populations with a consideration of additional constructs, such as geographic accessibility.

Development, content validation and standardization of an adult patient prioritization tool for hospital clinical pharmacy services

BACKGROUND

Patient prioritization is a effective strategy to identify high risk patients for targeted Clinical Pharmacy Service (CPS) in hospital pharmacy. However, there is a paucity of patient prioritization tool to use in clinical practice.

OBJECTIVES

Describe the development, content validation and standardization of an adult patient prioritization tool for hospital CPS named, PrioFarClinH.

METHODS

The tool was developed using a stepwise design multi: Scoping Review to identify prioritization criteria/sub-criteria; Delphi technique to obtain consensus under the identified criteria/sub-criteria; Survey with pharmacists evaluating applicability of the criteria/sub-criteria obtained from Delphi; Definition of criteria/sub-criteria to be included in PrioFarClinH attribution of scores. Content validation was performed by a panel of experts evaluating relevance, feasibility, clarity and adequacy of the score. Content Validity Index (CVI) was calculated. Standardization occurred through a retrospective observational study carried out at 24 and 72 h and median of the patient's hospital stay. An intragroup norm was performed, determining percentile ranks of the instrument's total scores. Patients with a P90 score were classified with a high level of prioritization for CPS.

RESULTS

PrioFarClinH is divided into three sections, with prioritization criteria for health issues; therapeutic classes; laboratory parameters. It comprises 51 criteria with specific scores with simple total calculation. None of the criteria presented CVI <0.78, maintaining the items from the initial version of PrioFarClinH. The scores were adjusted per suggestions from the panel of judges. Data were collected from 393 patients. The P90 percentile in the three hospitalization stages (24 h, 72 h, and median) was found, respectively, in the following scores: 18.0, 20.0, and 22.6.

CONCLUSIONS

PrioFarClinH is a comprehensive tool to target and to prioritize adults patients most likely to benefit from CPS. Evidence for adequate content validity was provided. However, further validation of this tool is necessary to establish tool performance.

Translation and psychometric evaluation of the Chinese version of the Nursing Time Management Scale

Background

Reasonable and effective time allocation can promote the improvement of medical care service quality. This study aimed to translate, cross-culturally adapt and validate the Chinese Nursing Time Management Scale (NTMS).

Methods

Using a cross-sectional survey, 345 clinical nurses were selected from June to September 2023 for a general information questionnaire and Nursing Time Management Scale (NTMS) study. Item analysis, exploratory factor analysis and validation factor analysis were used to verify the reliability and validity of the Chinese version of Nursing Time Management Scale.

Results

The Chinese version of the Nurses' Time Management Competency Scale includes 17 entries in 3 dimensions: planning activities and setting goals, coordinating activities and procedures, and organizing nursing activities. The Cronbach's alpha coefficient for the total scale was 0.966. Exploratory factor analysis showed that the cumulative variance contribution of the three male factors was 97.44%.

Conclusion

The NTMS has acceptable validity and reliability and can be used to evaluate the nursing time management skills of Chinese clinical nurses.

Reliability and Validity of the Chinese Version of the Nurses' Cancer Pain Management Competency Scale

BACKGROUND

The Nurses' Cancer Pain Management Competency Scale (NCPMCS) is a tool to explore nurses' competencies and subjective experiences in cancer pain management, and to help nurses understand their current shortcomings in cancer pain management. The scale, currently available only in English and translated into Chinese for wider adoption abroad, provides a tool for Chinese nurses to assess their level of cancer pain management. Furthermore, based on the scale's specific score, they can evaluate their lack of understanding about cancer pain management, advance research into this area, and enhance their capacity to control cancer pain while providing patient care.

OBJECTIVE

The purpose of this study was to translate and localize the new scale, and to measure its reliability and validity. The study was also to provide a way to quickly and accurately measure the competency of cancer pain management among nursing staff in China.

METHODS

The Bristling translation approach was used to translate, translate back, and culturally modify the English version of the cancer pain management competency scale for nurses to create the Chinese version. A convenience sample was used for the study, 220 clinical nurses from three Grade III hospitals in Zhengzhou, Henan Province, China, were chosen by convenience sampling. The Chinese version of the scale was used for this investigation.

RESULTS

The Cancer Pain Management Competency Scale for Nurses has 14 items over 4 dimensions in its Chinese form. From the exploratory factor analysis, four common components were recovered; the cumulative variance rate was 81.994%, the scale's Cronbach's α coefficient was 0.902, and the Cronbach's α coefficient for each dimension ranged from 0.800 to 0.938. Retest reliability was 0.915, scale content validity was 0.865, and Spearman-Brown's broken half reliability was 0.808.

CONCLUSION

Nurses' cancer pain management competency in clinics can be assessed using the Chinese version of the Nurses' Cancer Pain Management Competency Scale, which has strong validity and reliability.

A Practical Tool for Measuring Home-Based Cardiac Rehabilitation Self-Management Behavior: A Multiphase Cross-Sectional Study

BACKGROUND

Optimal self-management is the key to home-based cardiac rehabilitation for patients with heart disease. At present, there is a lack of a specific assessment tool to evaluate the home-based cardiac rehabilitation self-management behavior in patients with heart disease. Therefore, the aim of this study was to develop the Home-Based Cardiac Rehabilitation Self-Management Scale and validate its psychometric properties among patients with coronary heart disease.

METHODS AND RESULTS

A multiphase cross-sectional study was conducted that study covered 3 phases: (1) item generation and revision, (2) item evaluation and preliminary exploration, and (3) assessment of the psychometric properties of the scale. A scale with 21 items was developed to measure the home-based cardiac rehabilitation self-management behavior. The content validity index of the scale was 0.980. In exploratory factor analysis, the 5-factor structure supported by eigenvalues and screen plot explained 74.326% of the total variation. In confirmatory factor analysis, all fitting indicators were acceptable, further supporting the construct validity of the scale. The criterion validity of the scale was 0.783. In the reliability analysis, the Cronbach's α coefficient of the scale was 0.882, with a dimensionality range of 0.780 to 0.936. The split-half reliability coefficient and test-retest reliability coefficient were 0.774 and 0.770, respectively.

CONCLUSIONS

This study is the first to develop and validate a practical tool. This scale can comprehensively and accurately assess the self-management behavior of patients with heart disease in a home-based cardiac rehabilitation environment.

Assessment of Academic Resilience and Its Associated Factors Among Pharmacy Students in Twelve Countries

OBJECTIVE

Academic resilience, a critical determinant of academic achievement, is affected by various factors. There is a paucity of large-scale international assessments of academic resilience among pharmacy students. Therefore, this study aimed to assess academic resilience among pharmacy students in 12 countries and to evaluate factors associated with their academic resilience levels.

METHODS

A cross-sectional online survey-based study was conducted among randomly selected pharmacy students in 12 countries: Egypt, Türkiye, Indonesia, Pakistan, Bangladesh, Iraq, Jordan, Nigeria, Malaysia, Saudi Arabia, Sudan, and the United Arab Emirates. After pilot testing, the validated 30-item academic resilience scale (ARS) was used for the assessment. The data were collected between November 1, 2022 and April 15, 2023. Descriptive and inferential statistics were performed, as appropriate.

RESULTS

A total of 3950 were received from the 12 participating countries. The mean age was 21.68 ± 2.62 years. About two-thirds of the responses were from female participants and those studying for Bachelor of Pharmacy degrees. Overall, the findings show moderate academic resilience, which varied across countries. The median (IQR) of the total ARS-30 was 114 (103-124). Females exhibited lower negative affective and emotional response subscale levels than males. There were significant cross-country variations in the ARS-30 and all subscales. The highest overall levels were reported for Sudan, Pakistan, and Nigeria and the lowest were reported for Indonesia and Türkiye. Students in private universities tended to have higher overall ARS levels than public university students. Higher academic performance was significantly associated with ARS levels, whereas those with excellent performance exhibited the highest ARS levels. Students with exercise routines had higher ARS levels than those without exercise routines. Finally, students who were engaged in extracurricular activities had higher ARS levels than those who did not participate in these activities.

CONCLUSION

The study offers insights into the factors affecting academic resilience in pharmacy students across several countries. The findings could guide interventions and support activities to improve resilience and academic outcomes.

The Impact of Integration of E-Learning in Science: Applying Technology in Biology Classes as a Model

Background The most common teaching method in science is the lecture-based approach. E-learning is one of the advanced teaching methodologies that have gained attention in recent decades. It was hypothesized that the intervention of e-learning improved students' scores and satisfaction in biology classes. The purpose of this study was to determine if e-learning combined with traditional learning methods of lectures would improve unified students' scores and satisfaction in biology classes. Methodology The study design was a quasi-experimental approach. This study was conducted at the College of Science and Health Professions Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia. The study subjects comprised first-year female students (pre-professional program) in two different classes. The total number of participants was 150 (75 students in each group). The systematic random sampling technique was used. Randomly, one class (experimental group) received e-learning in addition to traditional lectures, and the other group (control group) received traditional lecture. The "Biology for Health Sciences" course was selected for this purpose. Scientific pre-test and post-tests were performed, and a satisfaction questionnaire was filled in for both groups. Results We found that e-learning and traditional lecture improved students' scores (P<0.01). Learning progress in the e-learning group was significantly more than that in the control group (P<0.05). Lecture has been shown to increase learning gains by 33%, and the integration of e-learning increased learning gains by 62%. Analysis of questionnaire results showed improved student satisfaction with the course in the study group. Conclusion The integration of e-learning approach significantly improved the retention and students' scores and satisfactions. E-learning could be applied more in pre-professional year science courses. According to these advantages, the quality of science education can be improved with this approach.

Enhancing educational technology practical course: Designing and validating tools for evaluating knowledge, performance, and satisfaction of public health students

Background

The present study was conducted with the aim of designing and validating questionnaires for evaluating the public health students' knowledge, performance, and satisfaction (KPS) in the course of educational technology.

Methods

The present study was conducted with qualitative-quantitative approach. Qualitative stage was done based on experts' opinion and related articles and questionnaires for developing, designing, and validating the tools. For validating the tools, face validity and content validity was done based on the opinion of the 10 expert panel. In quantitative stage, all initial validated tools were implemented on 50 students of public health for determining the reliability. The reliability of the tools was calculated using the internal consistency method of the items with Cronbach's ⍺ coefficient, and Kuder-Richardson. All analyses were conducted using SPSS-19 software.

Results

In the field of qualitative research, an assessment tool consisting of 20 four-option questions was designed. The content validity of this tool was confirmed based on the opinions of 10 educational experts, with CVI Total = 0.862 and CVR = 0.885. Additionally, the reliability of the tool was validated through testing on 50 public health students, resulting in a reliability coefficient of r = 0.780. Furthermore, for performance evaluation, four assessment tools each comprising 20 questions (totaling 80 questions) were designed. The validity values for these tools in the areas of PowerPoint (CVI = 0.981, CVR = 0.960), pamphlet (CVI = 0.866, CVR = 0.877), poster (CVI = 0.871, CVR = 0.906), role-playing (CVI = 0.871, CVR = 0.980), and the reliability of the tools with Cronbach's ⍺ r > 0.80 were confirmed. In the satisfaction assessment section, a researcher-made questionnaire consisting of 18 questions across seven domains was designed, with confirmed content validity (CVI = 0.949, CVR = 0.861) and reliability (r = 0.928).

Conclusions

It seems that this tool can be used to measure the KPS of students from the educational technology course of the health field and similar fields.

Worker's exposure to radiation in fluoroscopy, assessing and instruments: A systematic literature review

This review aims to identify and analyze the instruments employed for assessing the overall performance of workers exposed to fluoroscopy during surgical procedures and/or interventional procedures, using the PRISMA methodology. The studies were located through searches conducted on PubMed, Web of Science, Lilacs, ScienceDirect, B-ON, EBSCOhost, and EBSCO Discovery Service on March 27, 2023. Additional studies were identified using backward and forward citation techniques. The PEO strategic model was followed. The search spanned studies published between 2012 and 2022. The quality of the studies underwent assessment using the Joanna Briggs Institute checklist for analytical cross-sectional studies. Out of the 23 studies identified, encompassing 3604 individuals, 12 (52%) addressed the reliability and/or validity of the instruments, while 3 (13%) focused on the development and psychometric testing of the instruments. Only 5 instruments (23%), validated and reliable, exclusively evaluated occupational radiological protection. The predominant dimension covered was knowledge (82%, n = 19). The population was assessed in 18 studies, pre- and post-intervention in 2 studies, and 21 studies provided recommendations or tools for improvement. Individuals in the studies utilized passive dosimeters (ranging from 5% to 98%), thyroid shields (15% to 98%), and aprons or lead skirts/coats (28% to 99%). The evidence quality was moderate (6/8). This study underscores the imperative to enhance compliance with protective and monitoring equipment. Furthermore, additional information is warranted concerning the validity and reliability of the instruments used, as well as the development of instruments that are both valid and reliable.

Development of a head and neck lymphoedema specific quality of life tool: The Comprehensive Assessment of Lymphoedema Impact in the Head and Neck

PURPOSE

To develop a head and neck lymphoedema (HNL) specific quality of life (QoL) instrument to assess physical, functional, and social/emotional impacts of HNL.

METHODS

Instrument candidate items were reviewed by patients with HNL and clinicians and rated for importance, clarity, and invasiveness. The Content Validity Ratio was applied for item reduction. Three-step cognitive interviews were conducted with HNL patients to validate the items, survey format, and instructions.

RESULTS

Initially, 130 candidate questions were developed. Following item reduction, 52 items progressed to three-step cognitive interviews. Following cognitive interviews, the Comprehensive Assessment of Lymphoedema Impact in Head and Neck (CALI-HaN) included 33 items; 1 global, 10 physical, 7 functional, and 15 emotional.

CONCLUSIONS

Physical, functional, and socioemotional effects need to be considered when measuring QoL in patients with HNL. This study describes initial development of the CALI-HaN, an instrument that shows promise for clinical and research applications following future validation.

Factors influencing the intention to use the ICD-11 among medical record officers (MROs) and assistant medical record officers (AMROs) in Ministry of Health, Malaysia

The transition of ICD has never been a straightforward initiative. As nations transition to ICD-11, ensuring its acceptance among the users is essential. To our knowledge, there are limited studies about the instrument and ICD-11 adoption. Therefore, the purpose of this study was to design an instrument and investigate the factors influencing the intention to use the ICD-11 among medical record officers (MROs) and assistant medical record officers (AMROs) at Ministry of Health (MOH) Malaysia facilities. Based on the current literature, a model based on the decomposed theory of planned behaviour (DTPB) was proposed. The model consisted of 13 dimensions and 12 hypotheses identified from previous studies. Using PLS-SEM, 185 survey data points were analysed. The study findings showed that ten factors have a significant impact on the suggested model. Users' subjective norm was the most influential factor in their intention to use ICD-11. Unexpectedly, perceived usefulness and was found to have no significant influence. This study is important for policymakers in strategising ICD-11 implementation efforts. This study's novelty lies in applying a DTPB theory model in the context of the intention to use ICD-11.

Development and content validity of the cognition in daily life scale (CDL)

Cognitive impairment can negatively influence daily functioning. Current cognitive measures are essential for diagnosing cognitive impairment, but findings on these tests do not always represent the level of cognitive functioning in daily life. Therefore, this study aimed to design a structured measurement instrument to observe and rate the impact of cognitive impairment in daily life, named the cognition in daily life scale for persons with cognitive problems (CDL). In this paper we describe the development, expected usability, and psychometric properties (content and face validity) of the instrument. The CDL was established through three consecutive development phases: (1) item selection, (2) item categorization and comparison, and (3) item revision and manual construction. Subsequently, a panel of eleven international experts rated the relevance of the selected items and provided comments on the expected usability and face validity. Content validity was estimated with the content validity index, based on which four items were removed. The experts' comments led to minor adjustments of the manual, domains, and formulation of the maintained items. The final instrument consists of 65 items describing behaviour that relies on cognitive functions within six domains. Future research should focus on evaluating the construct validity and reliability of the CDL.

Assessment of the measurement properties of the Peabody Developmental Motor Scales-2 by applying the COSMIN methodology

The Peabody Developmental Motor Scales-2 (PDMS-2) has been used to assess the gross and fine motor skills of children (0-6 years); however, the measurement properties of the PDMS-2 are inconclusive. Here, we aimed to systematically review the measurement properties of PDMS-2, and synthesize the quality of evidence using the Consensus-based Standards for the Selection of Health Measurements Instruments (COSMIN) methodology. Electronic databases, including PubMed, EMBASE, Web of Science, CINAHL and MEDLINE, were searched for relevant studies through January 2023; these studies used PDMS-2. The methodological quality of each study was assessed by the COSMIN risk-of-bias checklist, and the measurement properties of PDMS-2 were evaluated by the COSMIN quality criteria. Modified GRADE was used to evaluate the quality of the evidence. We included a total of 22 articles in the assessment. Among the assessed measurement properties, the content validity of PDMS-2 was found to be sufficient with moderate-quality evidence. The structural validity, internal consistency, test-retest reliability and interrater reliability of the PDMS-2 were sufficient for high-quality evidence, while the intrarater reliability was sufficient for moderate-quality evidence. Sufficient high-quality evidence was also found for the measurement error of PDMS-2. The overall construct validity of the PDMS-2 was sufficient but showed inconsistent quality of evidence. The responsiveness of PDMS-2 appears to be sufficient with low-quality evidence. Our findings demonstrate that the PDMS-2 has sufficient content validity, structural validity, internal consistency, reliability and measurement error with moderate to high-quality evidence. Therefore, PDMS-2 is graded as 'A' and can be used in motor development research and clinical settings.

Empowering adult patients with diabetes for health educators' role within their family members: A cross-sectional study

BACKGROUND

Patient engagement as partners in diabetes prevention for family members/close relatives is a novel and underexplored approach. This paper aims to assess patients' willingness and confidence in their ability to succeed as health educators for their family members and investigate the influencing factors.

METHODS

A cross-sectional descriptive study was conducted between January 2023 and April 2023. A newly developed and validated self-reported questionnaire, based on the Health Belief Model (HBM) and previous research, was administered to a convenient sample of 134 adult participants diagnosed with diabetes. These participants sought care at primary healthcare clinics at King Abdul-Aziz Medical City, Ministry of National Guard Health Affairs in Riyadh and Jeddah (MNGHA). The data was examined using statistical methods including descriptive analysis, ANOVA, Tukey's HSD (Honestly Significant Difference) Post Hoc tests, and Pearson's correlation coefficients.

RESULTS

The majority of participants expressed a willingness to assume the role of health educators for their family members (n = 117, 87.31%) and reported a high level of willingness and confidence, as indicated by self-efficacy scores ranging from 12.00 to 25.00, with a mean of 21.12 (SD = 2.76). Participants' willingness to be health educators exhibited positive correlations with their perceptions of diabetes severity and susceptibility (r = .433, p < .01), perceived benefits and barriers (r = .451, p < .01), cues to action (r = .520, p < .01), self-efficacy (r = .789, p < .01), and the total score of the questionnaire (r = .640, p < .01).

CONCLUSIONS

The majority of participants expressed their willingness to assume the role of health educators for their family members, and a significant portion reported confidence in their capacity to accomplish this objective. Healthcare providers should emphasize the importance of equipping patients with the skills and knowledge necessary to effectively convey health messages and serve as health educators within their communities. This expansion of the approach holds the potential to have a significant impact on public health strategies for diabetes prevention.

Role of Grassroots Public Health Leadership in Bedouin Society in Israel in Reducing Health Disparities

Introduction

Negev Bedouin settlements suffer from poor infrastructure, and the population's health status is low across all indicators. While it is difficult for Bedouin citizens of Israel to integrate into the Israeli employment market, integrating this population into the health system is far-reaching. The aim of this study is to analyze the barriers and motivational factors experienced by Bedouin doctors to promote public health in the Bedouin community in southern Israel and to examine the perceptions these doctors have around the concept of leadership in a public health setting.

Methods

We conducted semi-structured interviews with Bedouin doctors from the Negev Bedouin community and analyzed them using thematic analysis.

Results

Most interviewees saw themselves as leaders whose role was to improve public health in their community. They stressed the need for health leadership in Negev Bedouin society, and their desire to lead change in the community from within. All interviewees had grown used to a different way of life and a higher standard of living, and as a result, had difficulty returning home. Interviewees presented that trust in the health system is a critical factor for the success of health promotion programs. However, they noted the evolving trends of general mistrust in the government and its institutions that form the infrastructure for mistrust in the health system. Lack of time and workload were barriers to exercising leadership. Interviewees reported their perception of how socioeconomic status, the standard of living, and lack of infrastructure, education, and training affect health outcomes and collaboration potential.

Discussion

This study presents a unique perspective on the views of doctors from the Negev Bedouin population on their involvement with grassroots leadership as a strategy to reduce health disparities in this community.

Unit-Based Nurses' Development of a Couplet Care Acuity Scoring Tool

OBJECTIVE

To evaluate content validity (CV) and interrater reliability (IRR) of an acuity scoring tool developed for the couplet care/postpartum/nursery patient population and to determine if there was agreement between supervisor or director scoring and staff scoring.

DESIGN

A scoring tool to assess the acuity of the couplet care/postpartum/nursery patients was developed.

SETTING

Two hospitals: one Level 2 hospital, one Level 3 hospital. Unit-based patient care councils participated in the development, and all couplet care nurses participated in scoring patients for testing.

MEASUREMENTS

The final tool was evaluated for CV and IRR using expert review, universal agreement scores, and discriminant content validation.

RESULTS

Regarding CV for the Couplet Care Acuity Scoring Tool, the average of the number of experts in agreement divided by the total number of experts across all items was 1.00. Regarding IRR, the intraclass correlation coefficient was 0.85, indicating that the tool is valid and reliable for the study sample.

CONCLUSION

The tool was reliable and valid in this study. Future testing is needed with larger samples and different health care facilities.