The reliability and factorial validity of the Swedish version of the Recovery Experience Questionnaire

Validation and psychometric evaluation of the French version of the recovery experience questionnaire: internal consistency and validity assessment

Background

Entrepreneurs often experience high levels of stress, anxiety, and burnout due to the demanding nature of their professional activities. Therefore, recovery from work-related stress is a relevant activity for entrepreneurs. The Recovery Experience Questionnaire (REQ) is a widely used 16-item self-reported measure covering four recovery factors: psychological detachment from work, relaxation, mastery, and control. The present study addresses the validation of a French version of the REQ.

Methods

A total of 1,043 French entrepreneurs from various sectors participated in this study. Internal consistency and correlations were examined to assess the psychometric properties of the French version of the REQ. Confirmatory factor analysis (CFA) was used to validate the four-factor structure of the REQ, with seven error covariances added to improve model fit.

Results

The French version of the REQ demonstrated good internal consistency (psychological detachment: α = 0.88, relaxation: α = 0.91, mastery: α = 0.90, control: α = 0.91). CFA supported that the four-factor structure was confirmed based on the following data: RMSEA = 0.071 (95% CI [0.066, 0.077]), CFI/TLI = 0.955/0.950, SRMR = 0.050, and χ2 (108) = 593.861, p < 0.001. Significant correlations were found between REQ scores and health indicators such as stress, loneliness, physical health, mental health, and sleep quality. The results confirm that the REQ is a valid and reliable measure for assessing recovery experiences among French entrepreneurs.

Conclusion

We conclude that the REQ is a valid measure and a useful tool for research on entrepreneurs' general health. Additionally, the validated French version of the REQ can be applied to other working populations, making it a versatile instrument for evaluating health and recovery in diverse occupational settings. To support this claim, we conducted the same validation analysis on a sample of 1,231 French agricultural employees, again showing that REQ is a valid and reliable measure for assessing recovery experiences.

Turkish adaptation of the state-trait anxiety inventory short version (STAIS-5, STAIT-5)

AIM

This study examines the validity and reliability of a Turkish version of the State-Trait Anxiety Inventory Short Version.

METHODS

The sample consisted of 306 people between the ages of 18-59 who agreed to participate in the study and met the inclusion criteria. Data were collected with the demographic questionnaire, State-Trait Anxiety Inventory Short Version, State-Trait Anxiety Inventory and Brief Fear of Negative Evaluation Scale.

RESULTS

All factor loadings of the State Anxiety Inventory Short Version were between 0.706 and 0.835, and those of the Trait Anxiety Inventory Short Version were between 0.694 and 0.810. The Cronbach alpha coefficients of the State and Trait Anxiety Inventory Short Version were calculated as 0.838 and 0.837, respectively. There was a significant difference between the first-test and retest values of the State Anxiety Inventory Short Version (p = 0.033) and no difference in the Trait Anxiety Inventory Short Version (p = 0.145).

CONCLUSIONS

The Turkish-adapted State-Trait Anxiety Inventory Short Version is a valid and reliable measurement tool to determine the anxiety levels of individuals aged 18-59.

Assessing Fear, Embarrassment, and Disgust in Colonoscopy: The Development of Measurement Instruments and Psychometric Evidence

BACKGROUND

Avoidance of colonoscopy is often associated with fear, embarrassment, and disgust aroused in screening procedures. However, each emotion can be linked to different challenges faced by patients. More research is needed to evaluate and address the causes of these respective emotions.

AIM

The purpose of this study was to develop and assess the scales of three negative emotions (i.e., fear, embarrassment, and disgust) caused by specific issues in colonoscopy screening.

METHOD

The measurement items were developed based on multiple common barriers in colonoscopy screening procedures. An online sample of 232 adults aged 45-75 was recruited from Amazon Mechanical Turk to test the scales. Explorative and confirmatory factor analyses were conducted to validate the measurement models.

RESULTS

Psychometric evidence demonstrated the factor structures of three negative emotions. Each emotional factor was caused by unique combinations of barriers in the preparation, screening, and recovery stages of colonoscopy. Most of the emotional factors were associated with attitudes and screening intention.

CONCLUSION

This study showed different dimensions of negative emotions and their underlying causes in colonoscopy. These findings will help assess specific causes of negative emotions in colonoscopy and develop effective interventions to improve screening uptake.

Validation of the Indonesian version of the Recovery Experience Questionnaire

This study aimed to validate the Indonesian version of the Recovery Experience Questionnaire (REQ-I) to assess how individuals unwind and recuperate from work during their off-job times, specifically in terms of psychological detachment, relaxation, mastery, and control. The translated and back-translated REQ, which has gone through semantic and face validation processes, was administered through an internet survey using 740 Indonesian workers from various backgrounds. Furthermore, confirmatory Factor Analysis (CFA) was conducted to evaluate factorial validity. Construct validity was evaluated based on the correlation coefficients between recovery experience and potential consequences variables, while internal consistency and test-retest reliability were investigated to evaluate the reliability. The result of CFA showed that the hypothesized four-factor model was the most suitable for the data. Meanwhile, construct validity was supported by expected correlations of recovery experiences with possible consequences. Cronbach's α coefficient for each of the four subscales was sufficient at 0.85-0.92. Test-retest reliability of each of the four subscales with three months intervals was confirmed with sufficient intraclass correlation coefficients at 0.60-0.66. This current study confirmed that REQ-I was an adequate measure of recovery experiences used in the Indonesian context.

A public value-based model to understand patients' adoption of eHealth: Theoretical underpinnings and empirical application

Objective

The main objective of this study is to develop an eHealth adoption model based on patients' perceptions of public value dimensions and empirically apply the model to understand the adoption of a governmental health app by Jordanian patients. The study attempts to contribute to overcoming the narrow focus of contemporary theories such as UTAUT and, ultimately, to designing more effective implementation strategies in order to address the current delays in global eHealth adoption.

Methods

We conducted a quantitative survey of 430 Jordanian patients, utilizing structural equation modeling (SEM) to process the empirical data. Specifically, we applied an SEM two-step approach that involved (a) evaluating the model-data fit through a review of the measurement model(s) and common method bias; and (b) analyzing the structural model.

Results

Our findings confirm that the proposed patients' value scale is valid and reliable. Its five dimensions (hedonistic motivation, utilitarian motivation, social value, ethical public value, and public trust value) significantly correlate with patients' public value, and the latter directly affects their use of eHealth apps, with habits mediating this relationship. Among the dimensions, hedonistic motivations tend to be prioritized over utilitarian ones. Ethical and trust values also play an essential role, particularly in how health technology handles patients' data and upholds their dignity and self-esteem.

Conclusions

This study highlights the holistic nature of eHealth adoption by patients and the crucial role of public values in their use behavior. It provides useful insights for policymakers and developers.

Learning how to recover from stress: Results from an internet-based randomized controlled pilot trial

•One of the first trials examining the efficacy of a brief preventive recovery training program in a sample of distressed employees.•Preliminary results suggest that employees across a wide range of professions could learn to recover, reduce stress, and improve quality-of-life.•This type of accessible and brief recovery intervention might shape the future of workplace stress prevention, however, more research is needed.

Validation of the vaccination attitudes examination scale in a South African context in relation to the COVID-19 vaccine: quantifying dimensionality with bifactor indices

BACKGROUND

The COVID-19 pandemic represented a global public health emergency. Existing studies support the view that vaccination and mass immunization are among the most effective means of containing the outbreak and promoting health. However, negative attitudes toward vaccination and the related vaccine hesitancy among many groups have created a significant barrier to effectively managing the health crisis. Having a valid and reliable tool to assess attitudes toward vaccination remains imperative so that factors underlying vaccine refusal can be identified and public health interventions can be facilitated. The current study examined the psychometric properties of the Vaccination Attitudes Examination Scale (VAX) in South Africa.

METHODS

Participants (n = 322) completed the VAX. Confirmatory factor analysis and ancillary bifactor indices were used to examine the hypothesized factor structure (a total scale and four subscales) of the scale. Inter-item correlations, factor loadings, and average variance extracted were used to examine the validity of the scale. Predictive validity was examined by comparing those who had received the COVID-19 vaccine and those who had not. The reliability of the scale was examined in terms of both Cronbach's alpha and composite reliability.

RESULTS

Confirmatory factor analysis provided support for the conceptualization of the scale as consisting of a total scale and four subscales, and ancillary bifactor indices indicated that the subscales accounted for a sufficient amount of variance (44%) after the variance explained by the total scale was considered. Overall, the analysis indicated that the scale had satisfactory reliability (alpha and composite reliability = 0.70) and provided evidence for the construct, convergent, and predictive validity of the VAX.

CONCLUSIONS

The sound psychometric qualities of the scale, when used in a low- to middle-income country, have the potential to advance research and immunization policy within these settings and facilitate more targeted interventions to promote vaccine uptake.

The role of therapist support on the efficacy of an internet-delivered stress recovery intervention for healthcare workers: a randomized control trial

Internet-delivered CBT interventions effectively improve different aspects of mental health, although the therapist's role remains unclear. The aim of this trial was to evaluate the efficacy of a therapist-supported 6-week internet-delivered intervention in improving stress recovery among healthcare workers compared to a group with optional therapist support. A total of 196 participants were recruited and randomly allocated to regular therapists' support or optional therapists' support groups. The primary outcome measure was the Recovery Experiences Questionnaire (REQ), developed to assess four components of stress recovery: psychological detachment, relaxation, mastery, and control. Secondary outcomes measured perceived stress (PSS-10), anxiety (GAD-7), depression (PHQ-9), and psychological well-being (WHO-5). All four stress recovery skills improved significantly after participating in the intervention at a 3-month follow-up, with small to medium effects (0.27-0.65) in both groups. At follow-up, we also found a significant reduction in perceived stress, depression, and anxiety in both groups, as well as an improvement in psychological well-being. The results indicate that ICBT can be effective in improving stress recovery skills among healthcare workers with optional support from the therapist, provided at the participants' request. This RCT suggests that optional therapist support could meet participants' needs and reduce resources needed in routine care.

Anxiety in Brief: Assessment of the Five-Item Trait Scale of the State-Trait Anxiety Inventory in South Africa

The current study examined the psychometric properties of a short form of the trait scale of the Spielberger State-Trait Anxiety Inventory. Participants consisted of a convenience sample of students (n = 322) who completed the five-item version of the trait scale of the State-Trait Anxiety Inventory, the Perceived Stress Scale, the nine-item version of the Beck Hopelessness Scale, the 10-item version of the Center for Epidemiological Studies Depression Scale, and the Post-Traumatic Stress Disorder Checklist. We used classical test theory and item response theory (Rasch and Mokken analyses) to examine the psychometric properties of a previously proposed five-item version of this scale. These approaches confirmed that the five-item measure of anxiety had satisfactory reliability and validity, and also confirmed that the five items comprised a unidimensional scale.

Internet-based stress recovery intervention for adolescents: study protocol for a randomized controlled trial

BACKGROUND

Research reveals a high prevalence of stressors in adolescence. Mental health in adolescence is highly related to life-stressors exposure and difficulties in adjusting to stressors. Therefore, interventions for recovery from stress are in high demand. The study aims to evaluate the efficacy of the Internet-based stress recovery intervention for adolescents.

METHODS

A two-arm randomized controlled trial (RCT) on the efficacy of the FOREST-A-an Internet-based stress recovery intervention for adolescents-will be conducted. The FOREST-A is an adapted version of stress recovery intervention initially developed for healthcare workers. FOREST-A is a third-wave cognitive behavioral therapy and mindfulness-based Internet-delivered 4-week psychosocial intervention, which comprises six modules: Introduction, Relaxation, Psychological detachment, Mastery, Control, and Summary. The intervention will be evaluated using the two-arm RCT with intervention and care as usual (CAU) condition at pre-test, post-test, and 3-month follow-up. The measured outcomes will be stress recovery, adjustment disorder, generalized anxiety and depression symptoms, psychological well-being, and perceived positive social support.

DISCUSSION

The study will contribute to the development of Internet interventions-easily and broadly accessible tools-for the enhancement of adolescents' stress recovery skills. Based on the study's findings, further development of the FOREST-A, including upscaling and implementation, is foreseen.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05688254. Registered on January 6, 2023.

Validation of the Recovery Experience Questionnaire in a Lithuanian Healthcare Personnel

Healthcare workers (HCWs) often experience high levels of stress, anxiety, and depression due to high workloads and responsibilities in their professional activities. Therefore, recovery from work-related stress is highly important in HCWs. The Recovery Experience Questionnaire (REQ) is a 16-item self-reported measure covering four stress recovery domains: psychological detachment from work, relaxation, mastery, and control. The current study aimed to test the REQ's psychometric properties in a sample of Lithuanian HCWs. In total, 471 HCWs from various healthcare institutions participated in this study. Confirmatory factor analysis (CFA) was used to test the structure of the REQ. We also used the Brief Patient Health Questionnaire (PHQ-4) and the World Health Organization Psychological Well-Being Index (WHO-5) to assess the mental health of the study participants. The CFA analysis supported the correlated four-factor structure of the REQ. Furthermore, we found significant correlations between the levels of REQ and anxiety, depression, and well-being. We conclude that the REQ is a valid measure that could be a useful tool in research on HCWs' mental health. It could also be used in healthcare settings for the evaluation of well-being among healthcare staff.

A Functionalistic Stress Recovery Intervention Improves Perceived Recovery Opportunities and Relaxational Behaviors: A Secondary Analysis of a Randomized Controlled Trial

The recovery perspective on stress management is new and few recovery intervention studies have been conducted. The aim of the study was to evaluate behavioral effects of a functionalistic stress recovery intervention, in which individuals perceiving high levels of stress were encouraged to pay attention to possibilities to perform potential recovery behaviors in everyday life and to choose behaviors that were predicted to lead to resource restoration. Seventy-three individuals were randomly allocated to either a 10-week intervention or a waiting-list control group. Three types of recovery behavior factors during leisure time were studied: perceived recovery opportunities (i.e., control), relaxational behaviors (i.e., relaxation), and positively challenging behaviors (i.e., mastery). In comparison with the control group, the intervention group significantly improved, showing high between-group effect sizes, regarding perceived recovery opportunities (p < 0.001; d = 0.75) and relaxational behaviors (p < 0.001; d = 0.80). Both groups normalized their levels of positively challenging behaviors between pre- and postassessment, and no statistically significant group difference was demonstrated. Analyses of reliable and clinically significant changes demonstrated results in favor of the intervention group regarding perceived recovery opportunities and relaxational behaviors but not positively challenging behaviors. The tested intervention warrants further research, for example, if a modified version of the intervention including components aiming at increasing postwork positively challenging behaviors would be beneficial for the improvement of the behavior and for health.

Causal Model Analysis of Police Officers' COVID-19 Fear, Resistance to Organizational Change Effect on Emotional Exhaustion and Insomnia

Since the end of 2019, COVID-19 has continued to spread around the world. The police have performed various epidemic prevention and routine duties. This study explores how police officers' COVID-19 fear, resistance to organizational change, intolerance of uncertainty, and secondary trauma affect emotional exhaustion and insomnia in the context of COVID-19. A total of 205 valid police samples were collected in this study, and the established hypotheses were tested using confirmatory factor analysis and structural equation modeling. The results of the study confirmed that during the COVID-19 outbreak, secondary trauma of police officers positively affects emotional exhaustion and insomnia; intolerance of uncertainty positively affects emotional exhaustion; resistance to organizational change positively affects intolerance of uncertainty and emotional exhaustion; intolerance of uncertainty mediates the relationship between resistance to organizational change and emotional exhaustion; COVID-19 fear positively influences secondary trauma.

Examining Risk Absorption Capacity as a Mediating Factor in the Relationship between Cognition and Neuroplasticity in Investors in Investment Decision Making

The encouragement of potential investors who are emotionally broken by past losses and market experiences is crucial to the sustainable flow of funds to the stock market. This can be established by building a knowledge-creating mechanism among investors in their cognitive dimensions, which, in turn, can develop their risk-bearing potential to reach the optimum level so that emotionally broken investors can use their cognitive abilities with their developed risk-absorption potential to further invest in the market in the near future. This study investigates the mediating effect of risk-absorption attitudes in the relationship between cognition and neuroplasticity in investors. Data for the study collected from 506 individual retail investors’ samples using a stratified random sampling technique were analyzed through covariance-based structural equation modeling. The findings of the study indicate that the constructs, viz., the investors’ cognition, risk absorption, and neuroplasticity, are valid and reliable. The structural model also supports the notion that risk absorption mediates the relationship between the investors’ cognition and neuroplasticity. The outcomes of the study are expected to aid in the policy formulation for equity-related financial product marketers, such as depository participants, brokers, mutual funds and SIP institutions, and to help in healing psychological trauma that potential investors suffered from due to losses in the past and overcoming reluctances to further invest in stock markets. The investors’ terrible psychological health developed because of past loss experience can be restored through the concept of neuroplasticity, in which different cognitive dimensions are used, while also enhancing risk absorption in potential investors.

Work-focused versus generic internet-based interventions for employees with stress-related disorders: A randomized controlled trial (Preprint)

BACKGROUND

In recent decades, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. The internet provides new options for broad dissemination, and a growing body of evidence suggests that web-based interventions for stress might be effective. However, few studies have examined the efficacy of interventions in clinical samples and work-related outcomes.

OBJECTIVE

The aim of this study was to evaluate the efficacy of an internet-based cognitive behavioral intervention for stress-related disorders integrating work-related aspects (work-focused and internet-based cognitive behavioral therapy [W-iCBT]), compared with a generic internet-based cognitive behavioral therapy (iCBT) group and a waitlist control (WLC) group.

METHODS

In this trial, 182 employees, mainly employed in the health care, IT, or educational sector, who fulfilled the criteria for a stress-related disorder, were randomized to a 10-week W-iCBT (n=61, 33.5%), generic iCBT (n=61, 33.5%), or WLC (n=60, 33%). Self-rated questionnaires on perceived stress, burnout, exhaustion, and other mental health- and work-related outcomes were administered before and after the treatment and at 6- and 12-month follow-ups.

RESULTS

Compared with the WLC group, participants of the W-iCBT and iCBT groups showed an equal and significant reduction in the primary outcome (Shirom-Melamed Burnout Questionnaire [SMBQ]) from pretreatment to posttreatment assessment (Cohen d=1.00 and 0.83, respectively) and at the 6-month follow-up (Cohen d=0.74 and 0.74, respectively). Significant moderate-to-large effect sizes were also found in the secondary health- and work-related outcomes. The W-iCBT was the only group that exhibited significant effects on work ability and short-term sickness absence. Short-term sickness absence was 445 days lower than the WLC group and 324 days lower than the iCBT intervention group. However, no significant differences were found in terms of work experience or long-term sick leave.

CONCLUSIONS

The work-focused and generic iCBT interventions proved to be superior compared with the control condition in reducing chronic stress and several other mental health-related symptoms. Interestingly, effects on work ability and short-term sickness absence were only seen between the W-iCBT intervention and the WLC groups. These preliminary results are promising, indicating that treatments that include work aspects may have the potential to accelerate recovery and reduce short-term sickness absence because of stress-related disorders.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05240495; https://clinicaltrials.gov/ct2/show/NCT05240495 (retrospectively registered).

Adoption of E-health platforms by medical practitioners: Mediating effect of attitude on E-health platforms usage

This study considers Theory of Reasoned Action and Technology Acceptance Model frameworks to test the mediating role of attitude towards using E-health platforms. 224 medical practitioners' responses are collected in the online mode. The mediation analysis supports the full mediation role of attitude towards using the E-health platforms in the relationship between perceived usefulness and intentions to use with (indirect effect = .15, SE = 0.03, LLCI = 0.09, and ULCI = .22). E-health platform developers should take active measures to improve the attitude of medical practitioners towards using such platforms, to derive the best results of the added features.

Internet-based stress recovery intervention FOREST for healthcare staff amid COVID-19 pandemic: study protocol for a randomized controlled trial

BACKGROUND

The demand for care during the COVID-19 pandemic has affected the mental health of healthcare workers (HCWs), thus increasing the need for psychosocial support services. Internet-based interventions have previously been found to reduce occupational stress. The study aims to test the effects of an Internet-based stress recovery intervention-FOREST-among HCWs.

METHODS

A randomized controlled trial (RCT) parallel group design with three measurement points will be conducted to assess the efficacy of an Internet-based stress recovery intervention FOREST for nurses. The FOREST intervention is a 6-week Internet-based CBT and mindfulness-based program which comprises of six modules: (1) Introduction, (2) Detachment (relaxation and sleep), (3) Distancing, (4) Mastery (challenge), (5) Control, and (6) Keeping the change alive. We will compare the intervention against a waiting list group at pre-test, post-test, and follow-up. Stress recovery, PTSD, complex PTSD, moral injury, the level of stress, depression, anxiety, and psychological well-being will be measured.

DISCUSSION

The study will contribute to the development of mental healthcare programs for the HCWs. Based on the outcomes of the study, the FOREST intervention can be further developed or offered to healthcare staff as a tool to cope with occupational stress.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04817995 . Registered on 30 March 2021.

A Cognitive Behavioral Model Proposing That Clinical Burnout May Maintain Itself

Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual’s clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.

Job Demand-Control-Support Model as Related to Objectively Measured Physical Activity and Sedentary Time in Working Women and Men

A physically active lifestyle incurs health benefits and physically active individuals show reduced reactivity to psychosocial stressors. However, the findings are inconclusive and are based on self-reported physical activity and sedentary time. The present study aimed at studying the associations between psychological stressors (job demand, control, support, JD-C-S) and objectively measured physical activity (PA) on various intensities from sedentary (SED) to vigorous physical activity. The participants were 314 employees from a cross-sectional study. PA data were collected with the accelerometer ActiGraph GT3X (Pensacola, FL, USA), SED data with the inclinometer activPAL (PAL Technologies Ltd., Glasgow, Scotland, UK), and psychosocial stressors with a web questionnaire. Results showed that vigorous-intensity PA was negatively associated with demand (β -0.15, p < 0.05), even when adjusted for the covariates. SED was negatively associated to support (β -0.13, p < 0.05). Stress significantly moderated relations between support and sedentary time (β -0.12, p < 0.05). Moderate PA (MVPA) was negatively associated with demand, but only when controlling for overtime (β -0.13, p < 0.05). MVPA was also negatively associated with control (β -0.15, p < 0.05) but not when work engagement was included in the model. Being more physically active and spending less time sedentary may help to handle job situations with high demand and low support.