Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline

Validity and reliability of the Turkish version of the patient on hemodialysis resilience scale

INTRODUCTION

The study aims to evaluate the validity and reliability of the hemodialysis resilience scale (PHRS) in the Turkish population.

METHODS

A cross-sectional methodologic study involved 136 hemodialysis patients at two dialysis centers affiliated with a foundation university in Turkey. The updated guidelines for the Intercultural Scale Adaptation Stages, Language, and Culture Adaptation were followed.

RESULTS

Cronbach's α of the PHRS-Tr was 0.94. A three-factor structure was extracted, namely "the pursuit of positive meaning in the present," "building the will to live through close human relationships," and "acceptance of hemodialysis as a part of daily life" explaining 66.82% of the total variance. Test-retest reliability was conducted with 50 patients within the sample 2 weeks after the first application. The correlation coefficient for test-retest reliability was r = 0.680.

CONCLUSION

The study results indicate that the PHRS-Tr is a valid and reliable tool for assessing resilience status in Turkish hemodialysis patients.

Reliability and validity of the Chinese version of the Benefit Finding Questionnaire for people with mental disorders

BACKGROUND

Benefit finding (BF) is correlated with mental health and recovery, and its presence will contribute to the recovery of patients with mental disorders. Most of the current tools for assessing BF in patients with somatic disorders are not adequate for patients with mental disorders. The present study proposes to introduce the Benefit Finding Questionnaire for People with Mental Disorders and to validate its psychometric properties.

METHODS

The Beaton translation model was used to translate and cross-culturally adjust the Japanese version of the Benefit Finding Questionnaire for People with Mental Disorders. A survey of 514 people with mental disorders was conducted from January 2022 to October 2022 using a general information questionnaire and a translated Chinese version of the Benefit Finding Questionnaire for People with Mental Disorders (BFQ-C) using a convenience sampling method. The quality of the questionnaire was examined in terms of item analysis, reliability, and validity.

RESULTS

The results of the item analysis showed that all items met the requirements. The interrater agreement of the BFQ-C was good, with an interrater agreement = 0.714; the values of the item-level content validity index ranged from 0.75 to 1.00; and the average of all item-level content validity index on the scale = 0.958. Exploratory factor analysis extracted three main factors "change in relationship with others," "change in spirituality," and "change in values and thinking styles"-and the cumulative variance contribution rate was 57.70%. The results of the confirmatory factor analysis were χ2/df of 2.194, Root Mean Square Error of Approximation of 0.075, and comparative fit index of 0.919, indicating that the model fitted well. The questionnaire had a Cronbach' alpha of 0.936, a split reliability of 0.956, and a retest reliability of 0.939.

CONCLUSION

The BFQ-C demonstrated good reliability and validity, and can be used to assess the BF level of people with mental disorders (e.g., anxiety disorders, depressive disorders, schizophrenia, and bipolar disorders) in China.

The Stirling Antenatal Anxiety Scale (SAAS): Turkish validity and reliability study

AIMS

To examine the psychometric properties of the Stirling Antenatal Anxiety Scale (SAAS), developed by Sinesi et al., which assesses the level of anxiety of pregnant women in the prenatal period, in the Turkish culture, and to conduct a validity and reliability study.

METHODS

This study had a methodological approach, with a cross-sectional and descriptive research design. Reporting was in accordance with the STROBE checklist. The sample included 160 pregnant women who were followed up in the maternity outpatient clinics of a public hospital and a private hospital in Istanbul. Data were collected face-to-face using a personal information form, the Turkish version of the SAAS, and the Generalized Anxiety Disorder-7 scale between June and August 2023. In the data analysis, validity analyses were performed with content and construct validity and multiple fit indices for confirmatory factor analysis. Item-total score analysis was conducted using Cronbach's alpha coefficient and Pearson's correlation analysis to assess reliability. Descriptive and reliability analyses were undertaken using SPSS v.28.0.1.0, and validity analyses were performed using SPSS AMOS v.26.0.0.0.

FINDINGS

Based on expert opinions on the items in the Turkish version of the SAAS, the content validity ratio was 0.96. The decision was made to exclude Item 9 from the Turkish version because the item factor load was low. The Turkish version had a single factor, as did the original version. The Cronbach alpha coefficient was 0.87, so the Turkish version was determined to have high reliability.

CONCLUSION

The Turkish version of the SAAS, originally produced in English, has high levels of validity and reliability. In addition, it is short and easy to apply in clinical and research settings. As such, the Turkish version of the SAAS is recommended for use to evaluate the level of anxiety in pregnant women.

The Professional Nurse Self-Assessment Scale II - Translation and cultural adaptation for Nordic countries

BACKGROUND

It is important to map the clinical competence of newly graduated nurses in Nordic countries. The use of a common Nordic instrument could provide insights into nurses' levels of self-assessed clinical competence and perceptions of their need for professional development.

AIM

To translate and culturally adapt the original Norwegian version of the Professional Nurse Self-Assessment Scale II (PROFFNurse SAS II) into (1) Danish, (2) Finnish and (3) Icelandic versions.

METHOD

The PROFFNurse SAS II was translated and cross-culturally adapted. This translation was inspired by the process used in the Guidelines for Cross-Cultural Adaptation.

RESULT

The translation and cultural adaptation processes employed the required steps and provided specific details. In addition, practical issues encountered during the translation process while translating and adapting instruments that may influence future translations were revealed. This study found that having a professional bilingual/bicultural agency translator was partly problematic in the process of translation and found that it is important to adjust the translations to each country's specific words used in nursing.

CONCLUSION

Translating the PROFFNurse SAS II instrument into all Nordic languages enables us to use the instrument from a Nordic perspective and across various countries. This is important when comparing self-awareness and reflecting on nurses' clinical competencies. Professional development is central to valuing and developing clinical competence and allowing for the discovery of gaps in clinical competence.

Translation and cross-cultural adaptation of the Yale Pharyngeal Residue Severity Rating Scale into Brazilian Portuguese

OBJECTIVE

To report the process of translation and cross-cultural adaptation of theYale Pharyngeal Residue Severity Rating Scale into Brazilian Portuguese.

METHODS

Methodological study approved by the Ethics Committee of the Institution (nº 5.166.256). The English original scale was translated into Brazilian Portuguese following suggested in the literature guidelines and recommendations after authorization from the authors of the original instrument, and involved the following reported steps of (1) Translation, (2) Synthesis of translations, (3) Determination of the applicability of the translated version 4) Back-translation, (5) Synthesis of the back-translated versions, and (6) Final synthesis. The translations and back-translations were performed by two bilingual translators. The research committee constituted three specialists who considered whether the linguistic, semantics, conceptual, idiomatic, and contextual equivalence of the translations and back-translations were. In Step 3, the raters consisted of three Speech-Language Pathologists and five ENT physicians divided into two subgroups (less than 5 years of professional expertise, and more than 5 years of professional expertise).

RESULTS

Step 1 was carried out properly by the translators, in Step 2 the translated version was prepared after minor adjustments. In Step 3, the raters reported that they found no difficulties in applying the scale. The Cronbach's Alpha coefficient was 0.995, demonstrating high internal consistency of the instrument, and the analysis of the Intraclass Correlation Coefficient (ICC) among the eight raters was 0.994 with a confidence interval between 0.990 and 0.998, demonstrating excellent agreement, regardless of experience. The research committee judged the last to be adequate and not to require adjustments.

CONCLUSION

The Brazilian Portuguese version of theYale Pharyngeal Residue Severity Rating Scale is presented in this study. This is a methodological study - No level of evidence.

Translation, cross-cultural adaptation and clinimetric properties of the Brazilian Portuguese version of the Brace Questionnaire

PURPOSE

To perform a cross-cultural adaptation and validation of the Brazilian-Portuguese versions of the Brace Questionnaire in adolescent idiopathic scoliosis.

METHODS

A forward-backward translation process was employed to produce a Brazilian Portuguese version of the Brace Questionnaire, followed by comprehensive cross-cultural adaptation stages. The measurements of internal consistency and test-retest reliability were assessed by Cronbach's a and intraclass correlation coefficient (ICC), respectively. The Pearson's correlation coefficient was used to analyze the concurrent validity by comparison with the Scoliosis Research Society-22r questionnaire.

RESULTS

A total of 84 scoliosis patients (age 13.4 ± 2.0 years, thoracic Cobb angle 33.3° ± 13.8°, and lumbar Cobb angle 29.8° ± 14.3°) were included. The Brace Questionnaire showed excellent internal consistency (Cronbach α = 0.93) and moderate reliability (ICC = 0.86). The correlations between the Brace Questionnaire and Scoliosis Research Society-22 were r = 0.66; p = 0.011. In addition, it was found that the Brazilian version of the Brace Questionnaire does not have ceiling and floor effects.

CONCLUSIONS

The Brazilian-Portuguese adaptation of the brace questionnaire shows excellent reliability and can be a valid tool for psychometric assessment in adolescent idiopathic scoliosis.

The Turkish adaptation of the Adherence to Asthma Medication Questionnaire

BACKGROUND

This study was conducted to adapt the Adherence to Asthma Medication Questionnaire (AAMQ-13) into Turkish.

METHODS

The research was conducted in the pulmonology outpatient clinic of a state hospital in Nigde/Turkey. The sample consisted of 229 volunteers with asthma for at least one year. First, language and content validity were assessed. After evaluating the language validity and content validity of the questionnaire, internal consistency, split-half reliability, and construct validity were examined. Questionnaire and demographic data were analyzed using numbers, percentages, dependent and independent groups t-tests, correlation analysis.

RESULTS

The AAMQ-13-TR has a Cronbach's alpha (α) score of 0.90 (p < 0.001). It has a split-half reliability coefficient of 0.86. The confirmatory factor analysis (CFA) shows that the factor structure of the AAMQ-13-TR agrees well with the two-factor model of the original questionnaire.

CONCLUSIONS

This study presented sources of evidence of validity of AAMQ-13-TR in Turkish population.

Cross-cultural validation and psychometric testing of the French version of the TeamSTEPPS teamwork perceptions questionnaire

PURPOSE

Effective teamwork is crucial for patient safety in healthcare. The TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) is a widely used tool for assessing teamwork perceptions. The T-TPQ has been adapted and validated for hospital setting use in several countries. This study aimed to translate and validate the T-TPQ into French for use among Tunisian healthcare professionals, enhancing teamwork assessment and patient safety initiatives.

DESIGN/METHODOLOGY/APPROACH

A rigorous process ensured cultural and linguistic adaptation of the T-TPQ, including back-translation, expert panel review, and pilot testing. 459 healthcare professionals from four hospitals in Kairouan, Tunisia participated. Confirmatory factor analysis (CFA) compared the original five-factor structure with a revised structure based on exploratory factor analysis (EFA).

FINDINGS

Both CFA models demonstrated good fit, with no significant difference between them (∆χ2 = 22.51, p = 0.79). The original five-factor structure was retained due to its established theoretical foundation. The French T-TPQ exhibited strong internal consistency (α = 0.9). Two-way Random ICCs indicated fair to good test-retest reliability for all the five dimensions (0.633-0.848).

RESEARCH LIMITATIONS/IMPLICATIONS

Several limitations should be acknowledged. The use of a questionnaire as a data collection tool is the source of a reporting bias, for fear of being identified or for reasons of "social desirability". Nevertheless, this social desirability was minimal, as Baker et al. (2010) took steps to mitigate this during the instrument's development. Additionally, for assessing attitudes and perceptions, self-reported measures are deemed more effective, whereas objective measures are advocated for behavioral assessments. Furthermore, the participants were informed of the absence of good or bad answers, the importance of answering as closely as possible, and the confidentiality. Moreover, considering the data collection period, the COVID- 19 pandemic and its potential impact on recruitment, data collection, and participant responses. Although the sample size of 459 met the recommended criteria for conducting confirmatory factor analysis, as suggested by Bentler and Chou (1987) and (Floyd and Widaman, 1995), the COVID-19 pandemic presented challenges in recruitment. The increased workload and stress on healthcare professionals, coupled with staff redeployment and research restrictions within hospitals and care units, likely hindered achieving an even larger sample size. These circumstances also necessitated adjustments to data collection methods to ensure safety and adherence to pandemic protocols. This involved incorporating online surveys option with paper-based questionnaires and implementing stricter hygiene measures during in person data collection. Furthermore, the pandemic impacted the teamwork perceptions as significantly redefined the healthcare environment, placing immense pressure on professionals due to surging patient volumes, staff shortages, and the emotional burden of caring for critically ill individuals. This heightened stress and workload likely influenced teamwork dynamics, potentially fostering both positive adaptations, such as increased cohesion and support, as well as negative consequences like communication breakdowns and decreased morale (Terregino et al., 2023).

PRACTICAL IMPLICATIONS

We outline significant practical implications for leaders in health care for improving teamwork and patient safety. Or, healthcare leaders can significantly enhance teamwork and patient safety by incorporating the validated French T-TPQ into their improvement strategies. This reliable tool enables the assessment of staff perceptions regarding teamwork strengths and weaknesses, specifically in areas like communication and leadership. By identifying these crucial areas, leaders can implement targeted training programs and interventions. In fact, the existing body of research consistently demonstrates the positive impact of team training interventions, on both teamwork processes and patient outcomes. These interventions have been shown to enhance teamwork skills (Baker et al., 2010; Thomas and Galla, 2013; Weaver et al., 2014). In areas such as communication, leadership, situation monitoring, and mutual support, leading to decreased mortality and morbidity rates (Weaver et al., 2014). Implementing team training programs fosters trust and collaboration around shared goals, contributing to a more effective and safer healthcare environment for both patients and professionals. Additionally, the culturally adapted T-TPQ not only benefits individual healthcare settings but also unlocks opportunities for broader research and collaboration on a global scale. By enabling cross-cultural comparisons and benchmarking, the T-TPQ can deepen our understanding of how teamwork dynamics vary across diverse healthcare environments and cultural contexts. This knowledge is invaluable for tailoring teamwork interventions and training programs to specific populations and settings, ensuring their effectiveness and cultural relevance. Moreover, integrating teamwork training into continuing professional development, interprofessional and medical education initiatives is crucial for cultivating collaborative competencies and building high-performing healthcare teams. Research has shown that interprofessional teamwork experiences significantly enhance collaborative competencies among nursing and medical students, emphasizing the importance of incorporating teamwork training early in healthcare education. This approach equips future healthcare professionals with the necessary skills to navigate complex team environments, ultimately improving patient care quality and mitigating workload issues that contribute to burnout (Simin et al., 2010; Ceylan, 2017; Fox et al., 2018).

ORIGINALITY/VALUE

The French version of the T-TPQ was semantically equivalent and culturally relevant with adequate test-retest reliability as compared to the English version, expanding its applicability and contributing to understanding teamwork perceptions in this context. The French T-TPQ offers a valuable tool for assessing teamwork, identifying areas for improvement, and implementing interventions to enhance teamwork and patient safety in Tunisia and potentially other French-speaking regions.

Behavioral, cognitive and emotional determinants of getting vaccinated for COVID-19 and the mediating role of institutional trust among young adults in Cyprus

BACKGROUND

Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual's health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions.

METHODS

A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey.

RESULTS

A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust.

CONCLUSIONS

When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated.

Perinatal Intimate Partner Violence and Maternal-Infant Bonding in Women With Anxiety Symptoms in Pakistan: The Moderating Role of Breastfeeding

Intimate partner violence (IPV) during the perinatal period can negatively affect both a woman's health and the bonding with her infant. Research on IPV among pregnant women experiencing psychological distress in South Asia is limited. We examined associations between perinatal exposure to IPV and postnatal maternal-infant bonding in Pakistani women with symptoms of anxiety and assessed if breastfeeding practices moderated these associations. Postnatal data were collected from 720 Pakistani women who reported at least mild levels of anxiety symptoms in pregnancy. We performed Poisson regression with robust variance analyses to examine the associations between IPV during pregnancy or within 6 weeks after delivery (i.e., the perinatal period) and maternal-infant bonding. Interaction terms between IPV and breastfeeding practices were included in the analytic models to examine the moderating effects. About 27% of women were exposed to at least one type of perinatal IPV. Women who were exposed to IPV were more likely to have moderate to severe postpartum anxiety (n = 57, 28.9% of IPV-exposed women), compared to those without IPV (n = 65, 12.4% of unexposed women; p value < .001). Compared to women not reporting IPV, women exposed to any IPV showed a 38% increase in Postpartum Bonding Questionnaire scores, suggesting higher likelihood of impaired bonding (risk ratio [RR] = 1.38, 95% confidence interval [CI] [1.21, 1.56]). Among women who initiated breastfeeding later than 1 hr post-delivery, IPV was associated with impaired bonding (RR = 1.09, 95% CI [1.06, 1.20]), whereas no association was present for women who initiated breastfeeding within 1 hr (RR = 1.03, 95% CI [0.98, 1.08]). In addition to the efforts to reduce IPV, encouraging IPV-exposed women to adhere to the breastfeeding guidelines (e.g., early breastfeeding) may enhance maternal-infant bonding.

Psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI)

BACKGROUND

Considering the vital role of nurses in responding to disasters, it is essential to measure their readiness with a valid and reliable tool. The present study aimed to assess the psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI).

METHODS

This cross-sectional study was conducted between 2023 and 2024 among 200 nurses working at educational hospitals affiliated with one of the medical universities in Tehran, Iran. The Disaster Nursing Readiness Evaluation Index was translated into Persian. The face, content, and construct validity, as well as internal consistency, were analyzed.

RESULTS

In the exploratory factor analysis, five factors were extracted: practical skills for disaster response, adaptability to stressful situations at the disaster site, communication and cooperation skills for teamwork, emergency nursing skills, and effective coping with daily stress. Together, these factors accounted for 39.7% of the total variance. The results of the confirmatory factor analysis indicated that the extracted model fit well: CMIN/DF = 1.519, CFI = 0.889, RMSEA = 0.051. The Cronbach's alpha and McDonald's omega coefficients for the entire questionnaire were 0.890 and 0.891, respectively.

CONCLUSIONS

Given that Iran is frequently exposed to disasters, it becomes essential to assess the preparedness of Iranian nurses using a valid and reliable scale. The availability of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI), which has undergone validation and reliability testing, facilitates accurate measurement of this concept.

Cross - cultural adaptation of the Low Vision Quality of life scale

INTRODUCTION

The quality of life related to visual function is a multidimensional construct that complements the functional assessment of patients with low vision. It shows the individual's perception of the course of ocular disease and its treatment within the framework of a value system and a sociocultural context. This clinical-epidemiological outcome is recognized as objective and valuable.

METHODOLOGY

A content validation study was conducted, which involved translating and back-translating the scale to evaluate semantic, idiomatic, conceptual, and experiential equivalence in the resulting version. The study included the participation of 21 individuals, and a quantitative evaluation was performed using Aiken's V coefficient to analyze the scores assigned in the categories of relevance and experiential capacity.

RESULTS

The questionnaire presentation was reorganized. The examples were expanded, and some optical aids were mentioned. Additionally, terms were changed to improve comprehension and reduce rudeness. Out of the 25 items, 11 had an Aiken V coefficient of less than 1.0.

CONCLUSIONS

The obtained version is comparable to the original questionnaire. However, the idiomatic twists specific to the local context emphasize the need for content validation to ensure correct interpretation and contribute to the updating of the scale.

Development of Valid and Reliable Questionnaire to Evaluate Knowledge, Attitude, and Practices (KAP) of Lifestyle Medicine Domains

Lifestyle medicine (LM) should be incorporated as part of routine clinical work and medical education programs.

OBJECTIVE

To develop and test the validity and reliability of a questionnaire that measures the level of knowledge, attitude, and practice (KAP) of LM domains among medical trainees through practicing physicians.

METHODS

The KAP questionnaire sections covered the nine domains of LM. The validation process included face and content validity. A total of 151 individuals from the medical field residing in Saudi Arabia were recruited through a convenient sampling technique to participate in the study. Item response theory (IRT) was applied to validate the knowledge domain, while exploratory factor analysis (EFA) was used to assess attitude and practice. Cronbach's alpha was performed to test the reliability of the three sections.

RESULTS

The questionnaire contained 37 items of knowledge, 45 attitudes, and 28 practice items. According to the IRT analysis, 27 items of knowledge were within the acceptable range of difficulty and discrimination. The EFA analysis resulted in 6 factors, including all the items in the attitude domain, and 4 factors, for a total of 27 items in the practice domain, with satisfactory factor loading (>0.4). The Cronbach's alpha for the three domains was very high (≥0.88).

CONCLUSIONS

The KAP questionnaire for LM is valid and reliable across a spectrum, from medical trainees to practicing physicians. This tool could serve as an instrument to evaluate and develop adequate educational programs for medical doctors.

Reliability and validity of the Chinese version of the doomscrolling scale and the mediating role of doomscrolling in the bidirectional relationship between insomnia and depression

BACKGROUND

Doomscrolling behavior is very common among college students. The purpose of this study was to evaluate the reliability and validity of the Chinese version of the Doomscrolling Scale, thus providing a scientific basis for its application among Chinese university students.

METHODS

The Chinese version of Doomscrolling Scale was developed through translation and revision of the original scale, conducting item and factor analysis, and validating it with validation factor analysis. The psychometric properties of the Doomscrolling Scale were assessed in 2885 Chinese university students.

RESULTS

The internal consistency coefficients, two-month test-retest reliability, and split-half reliability of the Chinese version of the Doomscrolling Scale (including the 15-item and the 4-item short version) were high, and the mono-factorial scales fitted well to the theoretical model. Scores on the Chinese version of the Doomscrolling Scale were significantly associated with depression, anxiety, and smartphone addiction. The structural equation model indicates that doomscrolling can mediate the bidirectional relationship between insomnia disorder and depression.

CONCLUSIONS

The revised Chinese version of the Doomscrolling Scale is valid and reliable, which can facilitate research in this field. The association between doomscrolling and various mental disorders has been confirmed, and further research should be conducted to investigate its mechanisms of action.

Knowledge and practices of neonatal intensive care unit nurses concerning hypothermia in preterm infants: A descriptive cross-sectional study

AIM

To investigate the knowledge level and clinical practice of neonatal intensive care unit nurses on the whole process of hypothermia prevention in preterm infants.

DESIGN

A polycentric descriptive cross-sectional study was conducted in 23 hospitals in Shandong province involving 254 neonatal intensive care unit nurses.

METHODS

An evidence-based knowledge and clinical practice questionnaire on hypothermia prevention in preterm infants and a general information questionnaire were used to collect data. SPSS and EXCEL 24.0 database were used for data statistics and analysis.

RESULTS

Nearly one-third of nurses were unclear about the definition of mild hypothermia and heat preservation measures during labour management and resuscitation. Knowledge about the correct rate of amniotic fluid evaporation was low. The higher the hospital level and nurses' education level, professional title, work experience, and position, the higher the knowledge level. The clinical practice of nurses differed in terms of body temperature assessment tools, measurement sites, and measurement frequency for premature infants.

CONCLUSIONS

Nurses in neonatal intensive care units need to apply evidence-based knowledge and carry out practice interventions to ensure preterm infants' safe transition from the delivery room to the neonatal intensive care unit.

IMPACT

There have been few studies evaluating neonatal nurses' knowledge and practices with regards to the preventing hypothermia of premature infants from delivery room to neonatal intensive care unit. The study identifies the deficiencies and problems in temperature management that can be attributed to the knowledge level of nurses. The findings will help improve the current curriculum, teaching strategies, and the nurses' knowledge levels, preventing premature hypothermia in infants.

REPORTING METHOD

This study adhered to the STROBE statement for observational studies and obtained approval (KYLL-2023LW045) from the ethics committee of The Second Hospital of Shandong University. The other 22 third- and second-level hospitals, as our alliance members, recognized our chairperson status within the alliance and were willing to join our academic activities. Mutual responsibility for ethical filing between alliance units.

PUBLIC CONTRIBUTION

254 nurses were recruited from 23 tertiary and secondary public hospitals in Shandong province. No public or patient involvement. Members of the research group used the Questionnaire Star platform to prepare the electronic questionnaire, including obtaining informed consent, taking precautions for questionnaire completion, and using the aforementioned measurement tools. The project research team contacted the head nurses of 23 neonatal intensive care units in Shandong Province. After obtaining consent from the head nurses, they were asked to send the requirements and link of the electronic questionnaire to their WeChat management group. The nurses go through each question and make a choice which has two options of 'agree' or 'disagree.' Based on their answers, nurses were evaluated as having 'mastered' or 'not mastered' each item. Each 'mastered' item (correct answer) was given a score of 4; an item 'not mastered' (incorrect answer) was given a score of 0. The total score ranged from 0 to 100.

Language discrepancies in the performance of generative artificial intelligence models: an examination of infectious disease queries in English and Arabic

BACKGROUND

Assessment of artificial intelligence (AI)-based models across languages is crucial to ensure equitable access and accuracy of information in multilingual contexts. This study aimed to compare AI model efficiency in English and Arabic for infectious disease queries.

METHODS

The study employed the METRICS checklist for the design and reporting of AI-based studies in healthcare. The AI models tested included ChatGPT-3.5, ChatGPT-4, Bing, and Bard. The queries comprised 15 questions on HIV/AIDS, tuberculosis, malaria, COVID-19, and influenza. The AI-generated content was assessed by two bilingual experts using the validated CLEAR tool.

RESULTS

In comparing AI models' performance in English and Arabic for infectious disease queries, variability was noted. English queries showed consistently superior performance, with Bard leading, followed by Bing, ChatGPT-4, and ChatGPT-3.5 (P = .012). The same trend was observed in Arabic, albeit without statistical significance (P = .082). Stratified analysis revealed higher scores for English in most CLEAR components, notably in completeness, accuracy, appropriateness, and relevance, especially with ChatGPT-3.5 and Bard. Across the five infectious disease topics, English outperformed Arabic, except for flu queries in Bing and Bard. The four AI models' performance in English was rated as "excellent", significantly outperforming their "above-average" Arabic counterparts (P = .002).

CONCLUSIONS

Disparity in AI model performance was noticed between English and Arabic in response to infectious disease queries. This language variation can negatively impact the quality of health content delivered by AI models among native speakers of Arabic. This issue is recommended to be addressed by AI developers, with the ultimate goal of enhancing health outcomes.

Cross-country adaptation and feasibility of an evidence-based resistance training intervention in the school setting

Background

Physical activity that strengthens muscles and bones at least three times per week are recommended, but few adolescents meet this target. The aim of our study was to adapt and evaluate the feasibility and preliminary efficacy of the Resistance Training for Teens (RT4T) program in Danish lower secondary schools.

Methods

Developed and evaluated in Australia, the aim of RT4T is to provide adolescents with competence, confidence, knowledge, and motivation to participate in resistance training. Translation and adaptation were based on the PRACTIS-guide and involved workshops with physical education teachers. Three 7th-grade classes and three 9th-grade classes were recruited for the feasibility study and followed the program over eight weeks. Participants completed a push-up test, a standing long jump test, and a beep-test before and after the intervention. In addition, they completed a survey about their self-efficacy, motivation, and resistance training competency. Four qualitative interviews were performed with participants and their physical education teachers.

Results

The participating teachers were motivated for the program, but they had difficulties providing students with appropriate feedback. Students were motivated by the equipment, games, and their improvements in fitness, but motivation declined during the program. A total of 57 students completed the physical tests and answered the survey. Resistance training self-efficacy improved significantly, while most other measures improved over time, without reaching significance.

Conclusion

Overall, the RT4T was acceptable and feasible in lower secondary schools in Denmark, but adjustments need to be made to increase the reach and efficacy of the program.

Cross-cultural adaptation and validation of the short nutritional literacy scale for young adults (18-35years) and analysis of the influencing factors

OBJECTIVES

This study translated the short nutrition literacy scale for young adults (18-35 years) into Chinese, examined its reliability and validity, and analyzed its influencing factors.

METHODS

The scale was translated using a modified Brislin translation model. A convenience sample of 508 cases was selected for the survey. Content validity, structural validity, Cronbach's alpha coefficient, and test-retest reliability were used to evaluate the scale's reliability and validity. To screen the factors influencing nutrition literacy in young people.

RESULTS

The Chinese version of the Item-Level Content Validity Index (I-CVI) was 0.833 ~ 1, and the Scale-Level Content Validity Index/Average (S-CVI/Ave) was 0.908. The cumulative variance contribution of the scale was 51.029%, and the model was generally well-fitted. The Cronbach's alpha coefficient and retest reliability of the scale were 0.826 and 0.818. The results showed that the level of education, mother's education, nutrition-related courses, and frequency of attention to nutritional health information were the factors influencing the nutritional literacy of young people.

CONCLUSION

The Chinese version of the S-NutLit Scale can effectively assess the nutrients of young Chinese people. Low levels of education, low levels of education of mothers, lack of exposure to nutrition-related courses, and low frequency of attention to nutritional health information can lead to lower levels of nutritional literacy among young people.

Cross-cultural adaptation and reliability of the European Portuguese version of the Musculoskeletal Health Questionnaire: A methodological study

PURPOSE

To culturally adapt the Musculoskeletal Health Questionnaire (MSK-HQ) to European Portuguese and evaluate its reliability in individuals with musculoskeletal conditions.

MATERIALS AND METHODS

The study was carried out in two phases. In the first phase, the MSK-HQ was translated and culturally adapted. In the second phase, a longitudinal observational study was carried out with a convenience sample of participants with musculoskeletal conditions. Data collection began at the start of physiotherapy treatments by filling in the MSK-HQ and Numeric Pain Rating Scale (NPRS). After 4-7 days, the participants were asked to fill out the MSK-HQ once again, as well as the Patient Global Improvement Change (PGIC) scale. The data collected was used to study internal consistency, test-retest reliability, and measurement error. Floor and ceiling effects were also analysed.

RESULTS

The MSK-HQ was successfully translated and adapted into European Portuguese. The second phase of the study had a sample of 191 participants. This study demonstrated high internal consistency (Cronbach's α = 0.885) and excellent test-retest reliability (ICC(2,1) = 0.908). The analysis of measurement error resulted in an SEM of 2.818 and an SDC at 7.811. No floor or ceiling effect was observed.

CONCLUSIONS

The MSK-HQ-PT is a reliable instrument for measuring musculoskeletal health. Further studies on its validity and responsiveness are needed.

Validity and Reliability of the German Vocal Fatigue Index in Adults With Voice Disorders

PURPOSE

Vocal fatigue-related symptoms, frequent in patients with voice disorders, are reliably quantifiable with the Vocal Fatigue Index (VFI) in several languages. The main aim of this work was to investigate the content and construct validity of the German Vocal Fatigue Index (VFI-D) by comparison with the German Voice Handicap Index 9 international (VHI9i) and the Vocal Tract Discomfort Scale (VTD). Moreover, the scale and retest reliability were investigated.

METHOD

In a prospective cohort study at two tertiary care hospitals, 93 adults with all types of voice complaints filled out the VFI-D, the VHI-9i, and the VTD. Eighty-one adults (Mage = 53.5 years, SD = 15.7) completed them one time, and additional 12 patients (Mage = 53.8 years, SD = 15.6) did a test-retest, completed them twice at an interval of 1 week. The validity was assessed by Spearman's rho and Mokken scaling and the reliability by a factor analysis and a two-tailed t test.

RESULTS

Mokken scaling has proven the VFI-D as one-dimensional questionnaire (one cluster, r = .95). All VFI-D items could be assigned to one of three factors according to principal component and principal axis factor analysis. Although Factor 1 related best to the VHI9i (∅ rs = .76) and Factor 2 to the VTD (∅ rs = .74), Factor 3 correlated moderately with the VHI9i (rs = .34) and weakly with the VTD (rs = .25). Results from the first and second VFI-D completion agreed strongly (t = -1.78, p = .10).

CONCLUSIONS

In this study, the content and construct validity of the VFI-D were confirmed. Also, both scale reliability with identical factors as those in the original study and retest reliability were verified. The VHI9i and VTD were highly indicative of VFI-D Factors 1 and 2, respectively. No correlation between Factor 3 and the other questionnaires was determined. Future research should evaluate which characteristics are specific to vocal fatigue versus general voice disorder-related symptoms.

Psychometric Properties and Assessment of Knowledge, Attitude, and Practice Towards ChatGPT in Pharmacy Practice and Education: a Study Protocol

ChatGPT represents an advanced conversational artificial intelligence (AI), providing a powerful tool for generating human-like responses that could change pharmacy prospects. This protocol aims to describe the development, validation, and utilization of a tool to assess the knowledge, attitude, and practice towards ChatGPT (KAP-C) in pharmacy practice and education. The development and validation process of the KAP-C tool will include a comprehensive literature search to identify relevant constructs, content validation by a panel of experts for items relevancy using content validity index (CVI) and face validation by sample participants for items clarity using face validity index (FVI), readability and difficulty index using the Flesch-Kincaid Readability Test, Gunning Fog Index, or Simple Measure of Gobbledygook (SMOG), assessment of reliability using internal consistency (Cronbach's alpha), and exploratory factor analysis (EFA) to determine the underlying factor structures (eigenvalues, scree plot analysis, factor loadings, and varimax). The second phase will utilize the validated KAP-C tool to conduct KAP surveys among pharmacists and pharmacy students in selected low- and middle-income countries (LMICs) (Nigeria, Pakistan, and Yemen). The final data will be analyzed descriptively using frequencies, percentages, mean (standard deviation) or median (interquartile range), and inferential statistics like Chi-square or regression analyses using IBM SPSS version 28. A p<0.05 will be considered statistically significant. ChatGPT holds the potential to revolutionize pharmacy practice and education. This study will highlight the psychometric properties of the KAP-C tool that assesses the knowledge, attitude, and practice towards ChatGPT in pharmacy practice and education. The findings will contribute to the potential ethical integration of ChatGPT into pharmacy practice and education in LMICs, serve as a reference to other economies, and provide valuable evidence for leveraging AI advancements in pharmacy.

Turkish Cross-cultural Adaptation of the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS)

PURPOSE

The purpose of this study is to cross-culturally adapt the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) to Turkish and test its validity and reliability.

DESIGN

This is a methodological study.

METHODS

This study was conducted with 121 children aged 1 to 12 years who underwent ambulatory surgery. The data of the study were collected using a Descriptive Information Form, PHBQ-AS, and the Parents' Postoperative Pain Measure. Data analysis and evaluation were performed using factor analysis, Cronbach's α analysis, item-total score correlation analysis, content validity, construct validity, and concurrent validity.

FINDINGS

PHBQ-AS showed a high level of internal consistency (Cronbach's α = 0.801). The item-total correlation values of PHBQ-AS were found to be 0.458 to 0.753. PHBQ-AS was determined to be a single-factor scale explaining 66% of the variance in the examined variable. PHBQ-AS and Parents' Postoperative Pain Measure scores were moderately correlated.

CONCLUSIONS

The Turkish version of PHBQ-AS was highly valid and reliable for the Turkish population. A recommendation for health care professionals in Turkey is to use the PHBQ-AS scale to evaluate posthospitalization behavioral changes in children who are admitted for ambulatory surgery.

Health and social care workers' professional values: A cross-sectional study

BACKGROUND

Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values.

RESEARCH AIM

To describe and compare professional value orientation among different health and social care workers in Finland.

RESEARCH DESIGN

A quantitative cross-sectional study.

PARTICIPANTS AND RESEARCH CONTEXT

We carried out an online survey of health and social care workers from 8 March to 31 May 2022, using the Finnish version of the Nurses' Professional Values Scale-3. The data were analysed using descriptive and advanced statistics.

ETHICAL CONSIDERATIONS

Permission was received from all participating organizations and those who completed the survey provided informed consent.

RESULTS

A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience.

DISCUSSION

Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified.

CONCLUSIONS

Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career.

Translation, cross-cultural adaptation, and validation of the Persian version of the Hospital for Special Surgery Anterior Cruciate Ligament Postoperative Satisfaction Survey

PURPOSE

With over 140 million speakers spread across Iran, Afghanistan, and Tajikistan, Persian, also known as Farsi, is a pluri-centric language. The purpose of this study is to perform cross-cultural adaptation and examine the validity and reliability of the Persian translation of the Hospital for Special Surgery Anterior Cruciate Ligament Post-Operative Satisfaction Survey (HSS ACL-SS).

METHODS

In this retrospective study, 102 anterior cruciate ligament reconstruction (ACLR) patients were asked to complete the Persian version of the HSS ACL-SS, Tegner scale, Lysholm score, the Single Assessment Numeric Evaluation (SANE) score, the Cincinnati Knee Rating System (CKRS), and the Visual Analogue Scale (VAS) for pain. Internal consistency was calculated via Cronbach's alpha coefficient. Validity was assessed with the correlations of Spearman's rho. 18 patients were included in the test-retest reliability assessment. The floor and ceiling effects of the examined content validity of HSS ACL-SS.

RESULTS

The Cronbach's alpha coefficient was computed at 0.959, showing outstanding internal consistency. The intra-class correlation coefficient (ICC) demonstrated excellent results (0.986, P-value < 0.001). Insignificant ceiling effects (2.9%) and floor effects (3.9%) were detected. The Persian version of the HSS ACL-SS score significantly correlated with the SANE (r = 0.730, p < 0.001), Lysholm score (r = 0.622, p < 0.001), and CKRS (r = 0.741, p < 0.001).

CONCLUSION

The overall performance of the Persian HSS ACL-SS was more than excellent in terms of reliability and validity. To conclude, Persian HSS ACL-SS may be used to assist patients in having a better perception of post-operative satisfaction.

The influence of supervisory support on clinical learning as experienced by Czech Nursing and health professional students in the context of patient safety events: A qualitative study

AIM

To explore the influence of supervisory and mentoring relationships on the clinical learning experiences of Czech Nursing and health professional students in the context of patient safety events BACKGROUND: Clinical experience is integral to healthcare education, shaping skills, behaviours, values and professional identity. During clinical placements, students may encounter memorable patient safety events and experience varied reactions from mentors/supervisors/others. Some research has highlighted challenges faced by students on clinical placement. Few studies involve multiple professions, most emanating from Western Europe, the UK, the USA and Australia with little relating to central European countries such as the Czech Republic.

DESIGN

Two stage interpretivist qualitative study based in social constructionism METHODS: Convenience sample across 13 undergraduate and 18 postgraduate health professions courses. Stage 1 (2022): using SLIPPS Learning Event Recording Tool translated into Czech. 20 students' (Midwifery=11, Nursing=1, Paramedic=1, Occupational therapy =7) submitted 21 patient safety learning event narratives. Stage 2 (2022): Focus group with 2 nursing and nine midwifery students. Phased thematic analysis involving multiple researchers.

RESULTS

Three themes illustrate the circumstances and impact of placement mentoring/supervision experiences, conceptualised as: 'Clinical and Emotional Companionship', 'Clinical and Emotional Abandonment' and 'Sense of agency - Professional and personal growth'. 'Companionship' reflected the students' feelings of being welcomed, respected, heard, trusted and supported. Conversely 'abandonment' emerged from feelings of being unheard, vulnerable, humiliated, afraid, leaving students feeling abandoned, lonely and 'useless'. Notwithstanding these conditions, students showed the ability to identify patient safety issues with agency evident in reactions such as stepping-in to try to ameliorate a situation, rather than speaking-up. Professional and personal growth was also apparent in their narratives and a conceptual diagram illustrates the students' learning journeys in a patient safety context.

CONCLUSION

The findings and new conceptualisations around abandonment and companionship emerging from this study expand the evidence base regarding the profound impact of clinical experience and mentorship/supervision on learning and students' emotional wellbeing. A sense of companionship appears to play a buffering role even in challenging circumstances of involvement in or witnessing compromised patients' safety. Allowing students a sense of belonging, to vent, grow, feel supported and safe to ask/learn - contributing to 'emotional safety for learning', promotes students' behaviour that may prevent/minimize hazards or ameliorate the aftermath. However, we must not simply blame mentors/supervisors, staff, or the students themselves- they are simply part of a much larger complex environment of professional education encompassing hidden curriculums, power dynamics and professional socialisation.

Is nature relatedness associated with better mental health? An exploratory study on Vietnamese university students

OBJECTIVE

This study aims to examine the relationship between nature relatedness (NR) on subjective positive well-being (life satisfaction) and mental disorders (depression, stress, and anxiety) in Vietnamese university students.

PARTICIPANTS

340 Hue University students voluntarily took part in the survey.

METHODS

The Nature Relatedness Scale, Depression, Anxiety, and Stress Scale and Satisfaction with Life Scale were used. Bivariate correlation, single regression, and moderation analysis were conducted to investigate the relationship between NR and the mental health of university students and the moderating role of NR.

RESULTS

Higher levels of NR significantly predicted higher levels of life satisfaction but did not significantly predict fewer symptoms of depression, anxiety, and stress. NR significantly moderated the link between life satisfaction and depression, anxiety, and stress.

CONCLUSIONS

The findings of this study imply that efforts to enhance students' mental health should include efforts to promote their NR.

Translation and cross-cultural adaptation of the Chinese version of the HLS-EU-Q47

The development of health literacy in China is relatively slow, and there are fewer health literacy scales, which is difficult to measure. Therefore, this study aims to promote the development of health literacy in China through the translation and application of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). The scale was translated into Chinese, back-translated, culturally adapted and finally subjected to psychometric evaluation. A multi-stage stratified sampling method was used to select 2504 residents to test the reliability and validity of a questionnaire on health literacy. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the validity of the results, and the back consistency was calculated by Cronbach's alpha coefficient. The EFA revealed that health care, disease prevention and health promotion explained 78.68% of the total variance in health literacy. The scale and its subscales demonstrated strong internal consistency, with high Cronbach's alpha coefficients ranging from 0.947 to 0.983. CFA confirmed the three-factor model's goodness-of-fit for the Chinese population. The dimensions of healthcare, disease prevention and health promotion showed high convergent validity with an average variance extracted values ranging from 0.52 to 0.60 and composite reliability values ranging from 0.94 to 0.96. The reliable and valid Chinese version of the HLS-EU-Q47 (HLS19-Q47-CN) developed and evaluated in this study is an important tool for assessing health literacy levels in the Chinese population. Furthermore, as this tool has global applicability, it has the potential to assess health literacy levels across different countries, enabling practical international comparisons.

The Oxford Utilitarianism Scale: Psychometric properties of a French adaptation (OUS-Fr)

It is well established that one's sense of morality may be readily influenced by one's culture, education, and life situation. Very few psychometric tools are currently available to measure facets of human morality in different cultures. Therefore, the purpose of the present study was to develop a French adaptation of the Oxford Utilitarianism Scale (OUS-Fr) and formally evaluate its validity. The OUS-Fr was developed through a process of back-translation and administered to a sample of 552 participants. Results from exploratory factor analyses revealed a bidimensional structure with satisfactory loadings that was then also supported in the confirmatory factor analysis check. The OUS-Fr scale demonstrated good psychometric properties, with acceptable internal consistency and coherent results in the convergent validity analyses. These findings contribute to morality measurement literature by providing evidence for the reliability and validity of the French adaptation of the OUS. The OUS-Fr can be viewed as a valuable tool for researchers and practitioners for assessing utilitarian tendencies within the French-speaking population, which could pave the way for cross-cultural understandings that are important for fully understanding the intricacies of human morality.

Patient-reported outcome measures in value-based healthcare: A multiple methods study to assess patient-centredness

OBJECTIVES

Value-based healthcare (VBHC) involves the use of standardised outcome measures, including patient-reported outcome measures (PROMs). This study aimed to assess to what extent discussion of PROMs is associated with patient- and person-centredness.

METHODS

This study used a separate sample pre-/post-test design and multiple methods (observations, questionnaires, and interviews) in a VBHC care pathway for patients with a vestibular schwannoma, to assess to what extent the implementation of PROMs is associated with a difference in patient- and person-centredness.

RESULTS

A total of 139 patients with a vestibular schwannoma and their four treating physicians were included in the study. No significant differences were found in observed patient-centredness (Mpre=6.71 ± 2.42 vs. Mpost=6.93 ± 2.01; P = 0.60) or patient-reported patient-centredness (Mpre=1.73 vs. Mpost=1.68; P = 0.63) and person-centredness after PROM implementation (Mpre=11.81 vs. Mpost=13.42; P = 0.34). We observed more discussion of patient-reported outcomes. However, a majority of patients did not expect PRO discussion in consultations.

CONCLUSIONS

The implementation of standardised PROMs in a VBHC care pathway was associated with more discussion on patient-reported outcomes in clinical consultations. Overall, the implementation of PROMs was not observed or perceived as leading to more patient-centred consultations.

PRACTICE IMPLICATIONS

Physicians should assess whether the discussion of PROMs add value collaboratively with patients.

Translation, cross-cultural adaptation and reliability testing of the barriers to physical activity and Disability survey (B-PADS) for Thai people with Spinal Cord injury

PURPOSE

The objectives of this study were to translate and culturally adapt the Barriers to Physical Activity and Disability Survey (B-PADS) into the Thai context and to assess its inter- and intra-rater reliability.

METHODS

Participants were experts in the field of spinal cord injury (SCI, n = 3), linguistic experts (n = 7), Thai-English bilingual speakers (n = 40), Thai physiotherapists (n = 8), and people with SCI living in Thailand (n = 43). The translation and cross-cultural adaptation of the B-PADS into the Thai context was conducted using a 6-step process; forward translation, reconciliation of the two translated versions, backward-translation, harmonisation, backward-translation of the revised version, and cognitive debriefing with potential users and target population. The reliability of the translated tool was assessed using Cohen's kappa (K) and McNemar's test.

RESULTS

The inter-rater reliability test demonstrated high-range agreement for the majority of statements (27 out of 38; Cohen's K > 0.60) in the Thai-B-PADS final version. The intra-rater reliability test revealed that the majority of the statements (29 out of 38) in the Thai-B-PADS final version obtained substantial (Cohen's K = 0.61-0.80, p < 0.05) to perfect agreement (Cohen's K = 1.0, p < 0.05). McNemar's test displayed no statistically significant differences amongst assessors (p > 0.05) for nearly all statements.

CONCLUSION

The Thai-B-PADS final version was successfully translated and culturally adapted for people with SCI.

Disability attitudes in healthcare scale: translation and cross-cultural validation into Arabic using various medical samples

PURPOSE

Cross-cultural adaptation of the Disability Attitudes in Health Care Scale (DAHCS) into Arabic to assess the attitude toward people with disabilities. The objective of this study was to: firstly, translate and cross-culturally adapt the DAHCS into Arabic and secondly, assess its psychometric properties. Further, the goal was to investigate bachelor medical students' and doctors' attitude toward people with disabilities and highlight the need to establish the scale's reliability and validity by employing various samples.

METHODS

A convenience sample of 201 medical students and 105 doctors was used. Arabic DAHCS factors were extracted and confirmed by Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA).

RESULTS

The findings revealed that medical professionals and students hold a positive attitude toward people with disabilities. The Mann-Whitney U and Kruskal-Wallis tests revealed no significant differences in the study's variables. EFA identified four factors. CFA showed a good fit to the model. Also, convergent and discriminant validity were achieved. Cronbach's Alpha and McDonald's Omega values for all factors were satisfactory. However, the study found a low value of Cronbach's Alpha and Omega for the fourth factor.

CONCLUSIONS

The DAHCS was cross-culturally adapted into the Arabic language and its validity and reliability were achieved.

Development and Evaluation of a Cognitive Battery for People With Schizophrenia in Ethiopia

BACKGROUND AND HYPOTHESIS

Cognitive difficulties significantly burdened people with schizophrenia (PWS). However, cognitive assessment is often unavailable in low- and middle-income counties (LMICs) due to a lack of validated and culturally adapted cognitive assessment tools. In this study, we developed and evaluated a culturally sensitive cognitive battery for PWS in Ethiopia.

STUDY DESIGN

This study was conducted in three phases. First, we selected appropriate tests through an instrument selection procedure and created a new battery. Then, we rigorously adapted the tests using culturally competent procedures, including cognitive interviewing and expert meetings. Finally, we tested the new battery in 208 PWS and 208 controls. We evaluated its psychometric properties using advanced statistical techniques, including Item Response Theory (IRT).

STUDY RESULTS

The Ethiopian Cognitive Assessment battery for Schizophrenia (ECAS) was developed from three different batteries. Participants reported tests were easy to complete, and the raters found them easy to administer. All tests had good inter-rater reliability, and the composite score had very high test-retest reliability (ICC = 0.91). One-factor structure better represented the data with excellent internal consistency (α = .81). ECAS significantly differentiated PWS from controls with 77% sensitivity and 62% specificity at a Z-score ≤0.12 cut-off value. IRT analysis suggested that the battery functions best among moderately impaired participants (difficulty between -0.06 and 0.66).

CONCLUSIONS

ECAS is a practical, tolerable, reliable, and valid assessment of cognition. ECAS can supplement current assessment tools in LAMICs for PWS and can be used to measure cognitive intervention outcomes.

Adaptation and psychometric investigation of the Gameful Experience Questionnaire (GAMEFULQUEST) in Brazilian Portuguese

Over the years, the use of questionnaires has become one of the most used methods for analyzing individuals' experiences. Especially in the area of gameful environments (e.g., games, gamification, and simulators), the Gameful Experience Questionnaire, a self-report instrument to measure gameful experience, became one of the most popular. Despite the instrument's popularity, there is no Brazilian Portuguese version, preventing studies from being carried out in Brazil (i.e., a country with more than 200 million inhabitants), where only 5.1% of the population have adequate English comprehension skills. To face this challenge, we conducted a cross-cultural adaptation of the Gameful Experience Questionnaire, providing a version of the questionnaire in the Brazilian Portuguese language. For this process, we conducted a mixed-methods (i.e., qualitative and quantitative) psychometric study (N = 384) organized in six steps (i.e., (i) translation, (ii) synthesis, (iii) experts evaluation, (iv) target audience evaluation, (v) adapted instrument application, and (vi) validation (i.e., confirmatory factor analysis)). The results indicate that the cross-cultural adaptation took place efficiently, where the resulting instrument maintained the psychometric properties of the original, measuring the construct of interest with similar effectiveness (i.e.,χ 2 / d f = 2.4, RMSEA = 0.061, CFI = 0.991, TLI = 0.989, GFI = 0.986 and SRMR = 0.061), enabling its application with Brazilian Portuguese speakers. With this study, we contribute to researchers and practitioners in the field of gameful environments by providing an instrument to measure gameful experience in the Brazilian Portuguese language.

Psychometric properties of the Persian short form of the Stigma of Suicide Scale

Objective

Suicide stigma is a major obstacle to suicide prevention, resulting in a decrease in mental help seeking. This study aimed to survey the psychometric characteristics of the Persian short form of the Stigma of Suicide Scale (SOSS).

Methods

This psychometric study was conducted on 956 people (EFA = 399 samples, CFA = 557) in 2022 to evaluate the validity (face, content, and structure validity) and reliability (Cronbach's alpha coefficient, McDonald Omega coefficient, and intraclass correlation coefficient) of the SOSS. The structural validity of the scale was assessed by confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).

Results

The scores of S-CVI/Ave and CVR for SOSS were 0.982 and 0.921, respectively. In the EFA section, three factors with eigenvalues above one were shown, and 60.60% variance of the scale was explained by these factors, and one question was eliminated due the factor loading less than 0.4 and also moving to an irrelevant factor. Finally, based on the goodness-of-fit indices (such as RMSEA = .077, CFI= .902, IFI= .903, GFI= .915), the Persian short form of SOSS was approved with 15 items and three factors of Glorification/Normalization (4 items), Stigma (7 items), Isolation/Depression (4 items). The McDonald Omega coefficient, Cronbach's alpha coefficient, and ICC for SOSS were 0.841, 0.834, and 0.881, respectively.

Conclusion

In this study, the Persian short form of the SOSS was approved with 15 items and 3 factors, and this scale is an appropriate instrument for determining the status of suicide stigma among general population.

Traumatic stress symptoms in civilians after the 2020 Nagorno-Karabakh war: The protective role of self-compassion and emotional intelligence

Exposure to war is linked to negative mental health outcomes. Self-compassion and emotional intelligence may foster post-war adjustment processes differently depending on the time since the event happened. This study examines post-traumatic stress symptoms (PTSS) in civilians exposed to the 2020 Nagorno-Karabakh war shortly after and 6 months post-conflict, while investigating self-compassion and emotional intelligence's protective role. War-exposed civilians self-reported on PTSS, self-compassion, and trait emotional intelligence at two phases. Results showed greater PTSS shortly after war relative to 6 months later. Lower self-compassion scores were related to more PTSS at the first phase, whereas lower emotional intelligence was associated with more symptoms 6 months later. These data show how war-exposed Armenians coped, highlighting individual characteristics' effects, and suggest varying resource utilization during post-war adjustment. Specifically, self-compassion may be a protective factor shortly after war, whereas emotional intelligence may protect individuals against having adverse health outcomes later on.

Cross-cultural adaptation and validation of the caregiver self-efficacy in contributing to patient self-care scale in China

BACKGROUND

Caregiver self-efficacy is crucial in improving patient outcomes and caregiver well-being, but there is a lack of suitable scales to assess this concept within the context of Chinese culture. This study aimed to cross-culturally translate the Caregiver Self-Efficacy in Contributing to Patient Self-Care (CSE-CSC) Scale and evaluate its psychometric properties using classical test theory and item response theory.

METHODS

The CSE-CSC scale was adapted using Brislin's translation model after obtaining authorization from the original author. A multicenter, cross-sectional study was conducted to assess the psychometric properties of this scale. Classical test theory was used to evaluate reliability (internal consistency, test-retest reliability), validity (content validity, structural validity, convergent validity), and floor and ceiling effects. Item response theory was employed to assess the fit of the rating scale model, reliability, item difficulties, and measurement invariance.

RESULTS

The translation and cultural adaptation process was completed. Classical test theory demonstrated good internal consistency (Cronbach's α = 0.935) and test-retest reliability (ICC from 0.784 to 0.829, p<0.001). The I-CVI and K* of each item ranged from 0.875 to 1.00 and 0.871 to 1.00. The first-order 2-factor model fit well (χ2/df = 3.71, RMSEA = 0.082, SRMR = 0.032, CFI = 0.973, TLI = 0.60). Convergent validity showed that the CSE-CSC scores had a strong positive correlation with three separate scales of the CC-SC-CII. There was no floor and ceiling effect in this scale. Rasch analysis showed that the CSE-CSC scale demonstrated a good fit to the rating scale model and exhibited excellent reliability (person/item separation index>2, person/item reliability coefficients>0.8). The Wright map showed that item difficulty matched the respondents' measured abilities. The analysis of differential item functioning (DIF) showed that all items were comparable in gender.

CONCLUSIONS

This study indicated that the CSE-CSC scale had good reliability, validity, difficulty degree, and measurement invariance. The CSE-CSC scale can be used to measure caregiver self-efficacy of Chinese patients with multiple chronic conditions.

Validation of the Portuguese version of the diabetes self-management questionnaire-revised (DSMQ-R) in people with type 2 diabetes mellitus

BACKGROUND

Reflecting people with diabetes' self-management activities is often required in both research and clinical practice. This study evaluated the measurement properties of the Portuguese version of the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) on a sample of people with type 2 diabetes mellitus (T2DM).

METHODS

Translation and cultural adaptation were conducted according to guidelines for cross-cultural adaptation and validation of healthcare measurement instruments. A cross-sectional study was performed including 365 people with T2DM in primary care. Reliability, construct validity, and criterion validity were analyzed.

RESULTS

The total scale of the translated DSMQ-R revealed sufficient internal consistency (alpha = 0.82), and most of the subscales performed adequately. The exploratory factor structure was robust, and confirmatory analysis showed a good model fit with the scale structure of the original scale. The scale scores correlated with the participants' last HbA1c estimates, supporting convergent validity, and convergence was confirmed by the adequate average variance extracted.

CONCLUSIONS

The Portuguese version of the DSMQ-R is a reliable and valid tool for gauging self-management behaviors in people with T2DM and their relationship with glycemic values.

Validity and Reliability of the Greek Version of Adult Vaccine Hesitancy Scale in Terms of Dispositional Optimism in a Community-Dwelling Population: A Cross-Sectional Study

Vaccine hesitancy is an important public health issue referring to concerns about the safety and efficacy of vaccination. Within a framework, this study aimed to assess the cultural adaptation, validity, and reliability of the Greek version of the adult Vaccine Hesitancy Scale (aVHS) as well as to identify the determinants of vaccine hesitancy among a large regional population in central Greece. A cross-sectional study was conducted enrolling 300 adults who had received primary healthcare services in the Health Centers and Local Health Units of the Magnesia Region from October to December 2022. The aVHS and the Life Orientation Test-Revised (LOT-R) were used to identify vaccine hesitancy and the dispositional level of optimism, respectively. For survey translation, the procedure of forward and backward translation was followed. Also, the aVHS was tested in a pilot study with a sample of 18 responders. Construct validity and internal consistency reliability were investigated via exploratory and confirmatory factor analysis and Cronbach's alpha coefficients, respectively. Simple and multiple linear regression analysis were used to determine predictors for vaccine hesitancy. Factor analyses indicated that the aVHS comprises two constructs ("lack of confidence" and "risk perception") explaining 68.9% of the total variance. The Cronbach's alpha of the total scale was 0.884, indicating its high internal consistency. Participants who lived in rural areas, had a lower annual income, and reported a lower level of optimism showed a higher lack of confidence in vaccination. On the other hand, people aged above 45 years old who had graduated from high school or elementary school and were unemployed showed greater aversion to the risks of side effects. Finally, certain socio-demographic characteristics were associated with vaccine hesitancy. Our data suggest that the aVHS is a valid and reliable instrument for measuring vaccine-related attitudes and perceptions in Greek society, providing meaningful insight into designing vaccination-related preventive interventions in the community.

Validation of the Brazilian Version of the Modified Scale for Delineating Advanced Practice Nursing Roles

OBJECTIVES

to validate the Brazilian version of the Modified Scale for Delineating Advanced Practice Nursing Roles.

METHODS

this was a methodological study for the clinical validation of an instrument, conducted with 207 nurses working in primary care. Exploratory and confirmatory factor analysis, Cronbach's alpha test, and z-test for proportion comparison were used.

RESULTS

the internal reliability of the scale was 0.944, with alpha greater than 0.80 in most domains, except for Education (0.786). In the exploratory factor analysis, considering the criterion of eigenvalue greater than one, eight factors were identified, explaining 79.38% of the variance. In the comparison of proportions, the adequate responses (≥ 2) in the domain of Comprehensive Direct Care, in both analyzed groups, were statistically equal. This domain had the highest score of adequate responses, followed by Education and Systems Support. Insufficient scoring was observed in the domains of Publication and Professional Leadership.

CONCLUSIONS

the instrument demonstrated stability and reliability to be used in the evaluation of advanced nursing practice.

A Persian validation of the burnout assessment tool

BACKGROUND

Burnout is an increasing public health concern. Its prevalence has extended across diverse professions globally, posing significant challenges to individuals, organizations, and society. This phenomenon has undermined employee well-being, productivity, and organizational effectiveness, making it a critical concern in contemporary work environments. The present study aimed to examine the adaptation and assess the validity of the Persian version of the Burnout Assessment Tool (BAT).

METHODS

The adaptation process included the translation and back-translation of the BAT. Data were collected on a sample of 580 teachers using the convenience sampling. The BAT-Persian and Utrecht Work Engagement Scale were administered to collect the data. The reliability, factorial structure of the BAT-C and BAT-S, and the convergent and discriminant validity of BAT-C and work engagement were explored.

RESULTS

Confirmatory factor analysis supported a four-factor structure for the core dimensions (BAT-C; exhaustion, mental distance, emotional impairment, cognitive impairment), and a two-factor structure for the secondary dimensions (BAT-S; psychological distress, psychosomatic complaints). In the second-order model, the item loadings on the four factors of BAT-C ranged from 0.35 to 0.85, and on two factors of BAT-S ranged from 0.63 to 0.89. The Persian versions of the BAT-C and BAT-S showed good internal consistency (respectively, α = 0.95 and 0.90). Additional evidence supports the convergent and discriminant validity of the BAT-GR. the BAT-C and its scales were negatively correlated with work engagement and dimensions (i.e., vigor, dedication, and absorption). Moreover, the BAT-S and its scales negatively correlated with work engagement and dimensions.

CONCLUSIONS

This study provided evidence that the Iranian version of BAT represents a reliable and valid tool for measuring burnout in the work context. A reliable and valid tool for assessing burnout in the Iranian workplace enables early detection of employee distress, allowing for timely intervention and support. This means that identifying the signs and symptoms of burnout in the early stages can prevent more severe consequences such as absenteeism, reduced productivity, or turnover.

Cross-cultural validation and Spanish translation of the Boston Interview to evaluate severely obese patients seeking metabolic/bariatric surgery

INTRODUCTION

obesity is a global health problem. Metabolic/Bariatric surgery (MBS) has proven to be one of the most effective methods for treating the most severe forms. However, a thorough evaluation and preparation of people seeking MBS is necessary. In Spain, there are no standardized interviews to carry out the psychosocial assessment of people seeking MBS. The Boston Interview for MBS (BIBS) is a recognized and flexible tool to evaluate the psychosocial factors.

OBJECTIVE

to present the process of translation into Spanish and cross-cultural adaptation of the BIBS.

MATERIALS AND METHODS

the reverse translation procedure was followed. To validate the translation, a multidisciplinary group of experts was formed. They were asked to rate the clarity of wording and cultural adaptation of the translation items. In addition, the translated interview was used to evaluate 173 patients seeking MBS who rated their satisfaction with the interview experience.

RESULTS

the evaluation of the translation by a group of experts was favorable (global mode and median were 3-excellent, IQR of 1). The overall percentage agreement of the adequacy of "cultural adaptation" of the text was 85.8 % (95 % CI, 0.784, 0.932) and of the "clarity of wording" was 84.7 % (95 % CI, 0.7644; 0.9286). Furthermore, it was well accepted by the majority of the patients interviewed (p(50) 10 out of 10).

CONCLUSIONS

the Spanish translation of the BIBS is available for the assessment of Spanish-speaking people seeking MBS. It was rated as having good fidelity to the original English version, and was deemed highly satisfactory by patients.

Translation and Adaptation of the Japanese Version of the Revised Parental Stressor Scale: Pediatric Intensive Care Unit

Introduction The physical, cognitive, and psychiatric disorders that occur in patients after leaving the intensive care unit (ICU) are collectively called post-intensive care syndrome (PICS). Moreover, PICS-family (PICS-F) refers to the long-term psychological and social disorders that occur in the family. The symptoms of PICS-F can be psychological, and stress is a known cause of these symptoms. The Parental Stressor Scale: Pediatric Intensive Care Unit (PSS: PICU) was developed to assess stress levels and related factors among the families of patients admitted to the PICU. It has been translated into several languages and was revised in 2021. However, a Japanese version of the revised PSS: PICU (J-R-PSS: PICU) has not yet been developed. This study aimed to develop a J-R-PSS: PICU and to test its acceptability for clinical use. Materials and methods A back-translation method, involving initial translation, review by bilingual experts, and subsequent re-translation to ensure accuracy, was used to develop the J-R-PSS: PICU. Families with patients in the PICU for >48 hours between November and December 2021 and those who were transferred out of the ICU were recruited. Moreover, the study documents with a QR code for a web questionnaire were provided and explained to family members. Stress scores and stressors of family members were collected from web questionnaires using the PSS: PICU as the primary endpoint. Other information about the patients and their families was collected from clinical records and questionnaires. Participants and an expert panel evaluated the clarity of each item, and the expert panel evaluated the relevance of each item. Results Twenty family members who met the inclusion criteria and provided informed consent were included. The J-R-PSS: PICU was developed using a back-translation method. For clarity, all items were clarified after a single modification by an interdisciplinary team. For relevance, all the items had a content validity index at an item level of ≥0.8 and a scale level of 0.94. Alpha coefficients were 0.93 for the overall scale and 0.69-0.97 for its subscales. Conclusion We developed the J-R-PSS: PICU with high content validity and internal consistency using a back-translation method.

The Sensory Processing Measure - Second Edition: A Critical Review and Appraisal

This paper aims to provide an overview and critique of the newly updated Sensory Processing Measure - second edition (SPM-2) to assist clinicians in understanding its strengths and limitations and in selecting an appropriate sensory processing scale that best meets their clients' needs. Using four established research methodological quality critique tools, the SPM-2's family of age-related versions was evaluated by administering the tools separately and discussed their scoring and findings to reach a consensus on all ratings. The tools identified several strengths and weaknesses of the SPM-2. The SPM-2's items on its age-related versions scored well in the criteria of internal consistency, test-retest reliability, explanation of the instrument design, construct validity, content validity, criterion validity and ease of administration, and scoring. However, a lack of normative data for participant groups outside of the United States, methodological limitations, and a lack of investigation into some important psychometric properties, particularly responsiveness, were identified as notable weaknesses of the SPM-2's items on its age-related versions based on the critique criteria. Overall, despite the areas needing further development and investigation, the SPM-2 is considered a psychometrically sound tool that provides a reliable and valid approach to measuring aspects of the sensory processing construct across the lifespan.

The Turkish version of the Postpartum Bonding Questionnaire (PBQ): Examination of the validity and reliability and scale structure

PURPOSE

The aim of this study is to investigate the validity and reliability of the Turkish version of the Postpartum Bonding Questionnaire (PBQ).

DESIGN AND METHODS

This methodological study was conducted with 250 women who presented to three family health centers in Istanbul/Turkey between April and June 2022 and met the sampling criteria. Validity analysis was performed using the content validity index, exploratory factor analysis, and confirmatory factor analysis. Pearson product-moment correlation and Cronbach Alpha reliability coefficients were used for reliability analysis.

RESULTS

To evaluate invariance of the instrument over time, test-retest measurements were conducted at least two weeks apart and showed no difference in mean scores (p > .05). Adjusted goodness-of-fit index >0.97 and comparative fit index >0.98 confirmed the construct validity of the Turkish PBQ. Each item had a content validity index of 96%. Corrected item-total score correlations ranged from 0.50 to 0.93. The Cronbach Alpha was found to be 0.96, indicating high internal consistency.

CONCLUSION

The results of this study show that the Turkish version of the PBQ is valid and reliable. It can be used as a measurement tool to determine the degree of maternal bonding in the postpartum period.

Mental health status among chronic disease patients in Bangladesh during the COVID-19 Pandemic: Findings from a cross-sectional study

Context

The COVID-19 epidemic has had a substantial influence on the mental health of chronic disease patients. However, there is a scarcity of research on them in Bangladesh.

Aims

This study aims to explore the prevalence of and identify the risk factors for depression, anxiety, and stress symptoms during the COVID-19 pandemic among people with chronic diseases in Bangladesh.

Materials and Methods

This cross-sectional study involving face-to-face and telephone interviews was carried out among Bangladeshi people diagnosed with chronic diseases between September and November 2020. The total sample size was 878, and a convenient sampling technique was used. Logistic regression analysis was performed to investigate potential influencing factors for depression, anxiety, and stress.

Results

The mean age of respondents was 50.10 years. Among them, 35.0%, 36.0%, and 29.0% suffered from depression, anxiety, and stress symptoms, respectively. In multivariable logistic regression, depression had a significant positive association with higher age (≥60 years), lower income, rural residency, and loss of close family members due to COVID-19. Anxiety had a significant positive association with higher age (≥40 years), lower education, lower income, rural residency, and loss of close family members due to COVID-19. Stress had a significant positive association with higher age (≥40 years), no income, rural residency, and loss of close family members due to COVID-19.

Conclusion

It is urgent to consider the risk of developing mental health distress among chronic disease patients, especially aged people, by health service providers and generate effective programs for emergency situations.

German Translation and Linguistic Validation of the LIMB‑Q: A Patient-reported Outcome Measure for Lower Extremity Trauma

Background

Lower extremity trauma can have a significant impact on a patient's quality of life. The LIMB-Q is a recently developed and validated patient-reported outcome measure that assesses patient-specific outcomes and experience of health care. The aim of this study was to translate and linguistically validate the LIMB-Q from English to German.

Methods

The translation was performed by combining World Health Organization and Professional Society for Health Economics and Outcomes Research guidelines. The process consisted of forward translations, a backward translation, expert panel meetings, cognitive debriefing interviews with patients, and several rounds of discussion and reconciliation with the creators of LIMB-Q. The goal was to obtain a culturally and conceptually accurate translation of LIMB-Q into German for use in Switzerland.

Results

From the two forward translations, there was one primary discrepancy between the two translators that was discussed to determine the most conceptually accurate translation. From the backward translations, there were 63 items that required discussion and re-translation. Nine patients participated in the cognitive debriefing interviews, which led to three items being modified. The translation process led to a linguistically validated and conceptually equivalent German version of the LIMB-Q.

Conclusions

The German (Switzerland) version of LIMB-Q is now available. This will offer a valuable tool for lower extremity trauma research and clinical care in German-speaking populations.

Prevalence of stress and types of coping strategies among adolescents (14-18 years) in collectivist communities

BACKGROUND

Stress is highly prevalent among adolescents and might lead to maladaptive coping.

METHODS

This cross-sectional study assessed the prevalence of stress and determined the types of coping strategies used by adolescents; and identified the predictors of stress levels among this cohort. The study recruited 1344 participants, aged 14 to 18 years, in schools. The study used the DASS-42 and the Brief COPE Inventory Scale for data collection. The findings of this study showed that more than two-thirds of adolescents suffer from stress, and moderate, severe, and extremely severe were 22.8%, 43.0%, and 16.8%, respectively. The most used coping behaviors among these adolescents were religious factors, with a Mean ± SD of (Mean 6.28 ± 1.16), followed by instrumental support (Mean 6.17 ± 1.18). The stress level has a significant negative correlation at (p < 0.001) with active coping (r = -0.183**), self-distraction (r = -0.190**), acceptance (r = -0.140**) and religion (r = -0.097**; P < 0.001). Binary logistic regression analyses revealed that the whole model had R2 (0.232); p < 0.005 and shows that those aged 15 had an odd of 0.272 to develop stress more than those at 18. Fathers' and mothers' education levels strongly influenced adolescents' stress levels. Those with an income between <500 and 500-750 Jordanian Dinars had an odds ratio of 5.241 and 3.514 of developing stress, respectively, compared to their counterparts.

APPLICATION TO PRACTICE

This study highlights the significance of developing health intervention programs and counseling services for managing adolescents' psychological well-being and provides valuable insights for policymakers on addressing mental health issues.

Urdu-Language Translation and Validation of the Ask Suicide-Screening Questions (ASQ) Tool: A Focus on Connotation and Context

Background Suicide is a significant cause of death in the world, and Pakistan, a low- and middle-income country, is no exception. Despite the increasing number of suicides, Pakistan does not have a validated suicide risk screening tool to identify suicide risk in the national language, Urdu, accurately. This study aims to translate and validate the Ask Suicide-Screening Questions (ASQ) tool into Urdu for suicide risk screening in Pakistan. Methodology We conducted this study at the Services Institute of Medical Sciences (SIMS), a large teaching hospital in Lahore, Pakistan, after receiving the approval of the SIMS Institutional Review Board. The study used a cross-sectional instrument validation study design. The inclusion criteria were youth and adults of both sexes aged 15-45 years, with an ability to understand, speak, read, and write in the Urdu language, who had no cognitive or intellectual limitation to consenting, and who were medically stable to participate. Exclusion criteria included any medical, physical, or cognitive unstable condition to consent or participate. We enrolled 300 participants in our convenience sample from the emergency department (ED), inpatient, and outpatient settings. The ASQ and the ASQ Brief Suicide Safety Assessment (BSSA) were translated and back-translated by Urdu language experts and modified to accommodate cultural and linguistic nuances. The clinician-administered BSSA Urdu version was used as a standard criterion to validate the ASQ by comparing the ASQ-Urdu responses vs. BSSA-Urdu responses. RStudio (version 2023.09.1+494) was used for statistical analyses Results The sample had an enrollment rate of 99.7% (300/301). The sample was 52% female (158/300); the mean age was 27.1 years (SD = 9.4), the overall screen-positive rate was 41.7% (125/300), and 9.3% (28/300) of the participants endorsed a past suicide attempt. In our sample, 35.9% (33/92) of outpatients, 32.2% (19/59) of inpatients, and 49.0% (73/149) of ED patients screened positive on the Urdu ASQ. The screen-positive rate was 16.9% (10/59) for participants aged 17 years and younger, 40.7% (35/86) for participants aged 18 to 25 years, and 51.6% (80/155) for participants aged 26 years and older. Compared to the criterion standard clinician-administered assessment, the Urdu ASQ had a sensitivity of 94.2% (95% confidence interval (CI) = 85.8%-98.4%), a specificity of 73.9% (95% CI = 67.7%-79.5%), a negative predictive value of 97.7% (95% CI = 94.2%-99.1%), and a positive predictive value of 52.0% (95% CI = 46.4%-57.6%). Conclusions The Urdu ASQ has strong psychometric properties, allowing healthcare professionals in Pakistan and worldwide with Urdu-speaking diaspora to identify individuals at risk for suicide efficiently. Utilizing cultural contexts in adapted screening tools improves the accuracy of suicide detection by ensuring that the tools are relevant, sensitive, and respectful to the cultural context of the individuals being assessed. High screen-positive rates in our pilot study underscore the need for early detection and intervention of suicide as a major global public health problem.

Validation of Moorong Self-Efficacy Scale among Chinese stroke survivors

PURPOSE

To examine the psychometric properties of a Chinese version of the Moorong Self-Efficacy Scale (MSES-C) among stroke survivors.

METHODS

A cross-sectional descriptive study was conducted with 160 stroke survivors recruited from the three neurology departments in China. Reliability, concurrent validity, and construct validity of the scale were determined.

RESULTS

The MSES-C whole scale showed good internal consistency with a Cronbach's α of 0.953. There was a moderate to a strong positive correlation between the MSES-C and Chinese version of the General Self-Efficacy Scale (r = 0.695, p < 0.000), a strong positive correlation between the MSES-C and Chinese version of the stroke specific self-efficacy scale (r = 0.801, p < 0.000), positive correlations between the MSES-C and Chinese versions of the Modified Barthel Index (r = 0.695, p < 0.000), and a negative correlation between the MSES-C and National Institutes of Health Stroke Scale (r = -0.511, p < 0.000). Known-group validity was also supported.

CONCLUSIONS

The MSES-C is a reliable and valid instrument for assessing self-efficacy in Chinese stroke survivors.

Public awareness, risk perceptions and behaviour towards antibiotic use in food-producing animals and antimicrobial resistance in Malaysia: A cross-sectional study

Antimicrobial resistance (AMR) is a growing global public health problem, particularly in low- and middle-income countries, including Malaysia. Understanding risk perceptions on antimicrobial use (AMU) in food-producing animals from the general public perspective is an essential component in addressing AMR. However, little is known about public risk perceptions of AMU and AMR in food-producing animals in Malaysia. The objectives of this study were to assess the level of awareness, risk perceptions, and behaviour regarding antibiotic use in food-producing animals and antimicrobial resistance and to examine the factors associated with risk perceptions and the relationship between knowledge, awareness, risk perceptions and behaviour among the general public in Malaysia. A cross-sectional survey was used. Both descriptive and analytical statistics were used to analyse data and present results. Correlation and regression analyses were conducted to examine the factors associated with risk perceptions and the relationship between risk perceptions and behaviour. A total of 416 individuals participated in the study. The majority of the participants (69.2 %) had low knowledge of antibiotics and antibiotic use in food-producing animals. The levels of awareness of antibiotic use and the perceived route of antibiotic resistance transfer were moderate. Participants had a high level of general risk perception (GRP) of antibiotic use, a moderate level of personal-level risk perception (PRP) of antibiotic resistance transmission, and a high level of societal-level risk perception (SRP) of antibiotic resistance transmission. Awareness of antibiotic use was a significant predictor of GRP (β = 0.27, 95 %CI: 0.12-0.31, P < 0.001). Awareness of route of resistance transfer was a significant predictor of PRP (β = 0.54, 95 %CI: 0.32-0.44, P < 0.001) and SRP (β = 0.47, 95 %CI: 0.32-0.46, P < 0.001). PRP is the only significant predictor of behavioural changes towards antibiotic use and antibiotic resistance (OR = 1.45 [1.02-2.07], P = 0.041). Overall, there is a general lack of knowledge and little awareness of antibiotic use and antibiotic resistance in food-producing animals in Malaysia. Risk perceptions were moderate to high and were significantly predicted by awareness of antibiotic use and route of resistance transfer. Personal-level risk perception was a significant predictor of behavioural changes aimed at reducing the risk of AMU and AMR. It is imperative to raise public awareness and understanding of the risks associated with AMU in food-producing animals. Risk communication should be emphasised to ensure the translation of public risk perceptions into behavioural changes.