Development and validation of a new tool to measure the facilitators, barriers and preferences to exercise in people with osteoporosis

Translation and validation of the Chinese version of the menstrual distress questionnaire

BACKGROUND

The Menstrual Distress Questionnaire (MDQ) is a commonly used questionnaire that assesses various symptoms and distress associated with the menstrual cycle in women. However, the questionnaire has not been completely translated into Chinese with rigorous reliability and validity testing.

METHODS

This study translated the Menstrual Distress Questionnaire Form Cycle (MDQC) from English into Chinese: MDQCC in two stages. First, it was translated forward and backward using Jones' model; second, to test the validity and reliability, 210 Chinese-speaking women were recruited through online announcements and posters posted between June 2019 and May 2020. Expert validity, construct validity, convergent validity, and factorial validity were determined using content validity index (CVI), intraclass correlation coefficient (ICC), composite reliability (CR), and exploratory factor analysis, respectively. For concurrent criterion validity, MDQCC score was compared with three existing pain scales. Reliability was evaluated using internal consistency across items and two-week test-retest reliability over time.

RESULTS

The CVI for content validity was .92. Item-CVI for expert validities among the 46 items ranged from .50 - 1; scale-CVI for the eight subscales, from .87 - 1; ICC, from .650 - .897; and CRs, from .303 - .881. Pearson correlation coefficients between MDQCC and short-form McGill pain questionnaire, present pain intensity, and visual analog scale scores were .640, .519, and .575, respectively. Cronbach's α for internal consistency was satisfactory (.932). ICC for test-retest reliability was .852 for the entire MDQCC.

CONCLUSION

MDQCC was valid and reliable for Mandarin Chinese-speaking women. It can be used to evaluate female psychiatric symptoms related to the menstrual cycle in future work.

Validity and reliability of the new NIMHANS intellectual disability screening instrument (NID-Screener) for children and adolescents in India

INTRODUCTION

There is a gap in tools specifically designed for assessing Intellectual Disability (ID) in Indian settings. To address this, the NIMHANS intellectual disability screening instrument (NID-Screener) was developed by the Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences.

METHODS

Ten non experts/language and ten experts rated face and content validity of NID-Screener respectively. Content validity was measured by Content Validity Ratio, Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Construct validity was calculated by performing Exploratory Factor Analysis(EFA) on responses from 275 parent(s)/guardian(s) of children and adolescents (6-17 years). Criterion Validity was tested against Brief Intellectual Disability Scale (BIDS) and Clinical Diagnosis by Child and Adolescent Psychiatrist. Kappa Statistics was used to calculate inter - method and inter-Rater Reliability. Cronbach's alpha was used to assess Internal Consistency. This study was approved by NIMHANS ethics committee.

RESULTS

Findings revealed that NID-Screener has good face and content validity (S-CVI/Average = 0.917). Criterion Validity was excellent (Kappa Value=0.862, p-value<0.001) when compared with BIDS. Sensitivity and specificity were found to be 84.7 %, 89 % respectively against Clinical Diagnosis. On EFA, only one underlying factor with Eigen value > 1 was identified (55.8 % of total variance). Kappa value was found to be 0.971 and 0.942 for inter- rater and inter -method reliability respectively(p-value<0.001). NID-Screener has good internal consistency [Cronbach's alpha = 0.841].

CONCLUSIONS

NID-Screener is a reliable and valid tool for screening ID among children and adolescents in India, facilitating its early detection through diagnostic assessments and subsequent interventions.

Neonatal acuity tool-defined staffing ratios in a tertiary Australian neonatal intensive care unit

AIMS

There is well-established data linking the adequacy of nurse staffing to patient outcomes. Evidence-based standards for staffing are therefore critical to drive improvements in clinical care. One such evidence-based approach is the use of patient acuity-based tools. The objective of this study is to determine the performance of a neonatal acuity tool in an Australian tertiary neonatal health-care setting, focusing on the classification of patient acuity and nursing:patient staffing ratios compared to current practice.

METHODS

Acuity data were collected in a neonatal intensive care unit (NICU) and special care baby unit (SCBU) over a 10-week period in 2023. Patient data were scored in the 16 domains at two time points (prior to morning and evening nursing shift changeover) for all admitted newborns.

RESULTS

For ventilated newborns nursed with a nurse:patient staffing ratio of 1:1, 78% of scores were within the L4-high acuity (score ≥ 26) band, with the remaining scores within the L3-high acuity (18-25) band. For newborns on non-invasive respiratory support in NICU staffed 1:1, the proportion scoring within the L4 acuity band was higher in the nasal high-flow group compared to the nasal continuous positive airway pressure group (P = 0.032), an effect not seen for those nursed 1:2 in NICU or for those on nasal high-flow nursed in SCBU either 1:2 or 1:3.

CONCLUSION

This study of how a neonatal acuity classification system compares with current nurse:patient staffing allocations in an Australian tertiary NICU, suggests refinements in staffing ratios for specific patient groups on respiratory support are possible.

Practice recommendations for culturally sensitive communication at the end of life in intensive care: A modified eDelphi study

BACKGROUND

Clinicians need specific knowledge and skills to effectively communicate with patients and their family when a patient is dying in the ICU. End-of-life communication is compounded by language differences and diverse cultural and religious beliefs.

AIM

The aim was to develop and evaluate practice recommendations for culturally sensitive communication at the end of life.

METHOD

Modified two-round eDelphi study. An Australian national sample of 58 expert ICU clinicians of nursing and medical backgrounds participated in an online survey to rate the relevance of 13 practice recommendations. Ten clinicians participated in a subsequent expert panel interview to provide face validity and comprehensive details about the practical context of the recommendations. Survey data were analysed using descriptive statistics, interview data using deductive content analysis.

RESULTS

All 13 practice recommendations achieved item content validity index (I-CVI) above 0.8, and scale content validity index (S-CVI) of 0.95, indicating sufficient consensus. Recommendations prioritising use of professional interpreters and nurse involvement in family meetings achieved near perfect agreement amongst participants. Recommendations to facilitate family in undertaking cultural, spiritual and religious rituals and customs, advocate for family participation in treatment limitation discussions, and clinician access to professional development opportunities about culturally sensitive communication also achieved high level consensus.

CONCLUSION

These practice recommendations provide guidance for ICU clinicians in their communication with patients and families from culturally diverse backgrounds.

IMPLICATIONS FOR CLINICAL PRACTICE

Clinicians want practice recommendations that are understandable and broadly applicable across diverse ICU contexts. The high consensus scores confirm these practice recommendations are relevant and feasible to clinicians who provide end-of-life care for patients and their family members. The recommendations also provide clear guidance for ICU leaders, managers and organisational policy makers.

Preliminary development and validation of the Indonesian Pediatric Epilepsy Questionnaire (INA-PEPSI) to determine epilepsy and distinguish focal and generalized epilepsy in infants and children with unprovoked seizure in low-resource settings

OBJECTIVE

To outline the preliminary development and validation of a questionnaire for diagnosing epilepsy and distinguishing focal and generalized epilepsy among infants and children in Indonesia, where electroencephalography and pediatric neurologists are generally not available.

METHODS

A 10-question questionnaire comprising of 43 items was developed through literature review and expert panel discussions. Then, the questionnaire was administered by pediatricians to 75 children aged 1 month to 18 years old presenting with >1 episode of unprovoked seizures at an interval of >24 h. Subsequently, the questionnaire was assessed for content validity with item-level and scale-level content validity indices and ratio, construct validity with item-total correlation tests, criterion validity with diagnostic parameter assessments, and inter-rater reliability using Cohen's kappa (κ) and internal consistency with Cronbach's alpha (α) coefficient.

RESULTS

The questionnaire exhibited favorable internal validity and reliability in diagnosing epilepsy and distinguishing focal and generalized epilepsy, with excellent content (both indices and ratio at 1) and construct validity (rcount > rtable at p < 0.001), inter-rater reliability (κ = 0.86 and κ = 0.84), and internal consistency (α = 0.634 and α = 0.806). The questionnaire had a sensitivity and specificity of 96.4% (95%CI 89.1-99.5%) and 95.0% (79.5-99.6%) (area under the curve [AUC] 0.946 [0.900-0.992, p < 0.001]) in diagnosing epilepsy and 80.0% (57.4-95.7%) and 97.4% (89.7-99.2%) (AUC 0.889 [0.783-0.995, p < 0.001]) in distinguishing focal and generalized epilepsy, with a misdiagnosis rate of 4.0%.

SIGNIFICANCE

The questionnaire shows promising potential in diagnosing epilepsy and distinguishing focal and generalized epilepsy. Further external validation studies in larger and more diverse populations are required to confirm our findings.

PLAIN LANGUAGE SUMMARY

The diagnosis of epilepsy in children is challenging, particularly in resource-limited settings such as Indonesia, where advanced diagnostic tests and pediatric neurologists are scarce. The Indonesian Pediatric Epilepsy Questionnaire (INA-PEPSI) is designed to address these limitations by enabling healthcare professionals in Indonesia to diagnose epilepsy and classify its types without relying on advanced diagnostic tools. Although the questionnaire is still in the early stages of development and validation, this study demonstrates that the questionnaire exhibits good overall diagnostic performance in diagnosing epilepsy and distinguishing epilepsy types among Indonesian children.

Development and validation of a knowledge, attitude, and practice questionnaire regarding exercise and exergames for obese patients with gout

The Knowledge-Attitude-Practice (KAP) Questionnaire could help investigate whether there are misconceptions, positive attitudes, and adequate practice in people with gout about exercise and exergames. The study aims to develop and validate the KAP questionnaire regarding exercise and exergames for obese patients with gout to understand gout 'patients' awareness level of exercise and perception of exergames. The development and validation of the questionnaire involved two phases: (1) development of the instrument and (2) judgment of the instrument through calculating the content validity by the expert panel and using SPSS version 28 to examine the test-retest reliability, internal consistency, and structural validity of the instrument. After the first phase of instrument development, an initial questionnaire consisting of six parts with 35 items was identified. After the content validation of the second phase, 11 items with a content validity ratio (CVR) value below 0.99 were eliminated, 3 items were rephrased, 2 items that mixed two statements were divided, and 15 items were added based on the original instrument. In addition, in the factor analysis, five items within the knowledge domain with factor loadings below 0.4 were removed. The final questionnaire was examined and demonstrated acceptable content validity, test-retest reliability, internal consistency, and construct validity.

Development of knowledge, attitude and practice questionnaires on e-Huffaz ProHealth, a multicomponent lifestyle intervention module among Tahfiz students

e-Huffaz ProHealth is a lifestyle intervention module developed specifically for Tahfiz students. The e-Huffaz ProHealth consists of physical health, nutritional and psychological components. This study aimed to develop the knowledge, attitude and practice (KAP) questionnaires on e-Huffaz ProHealth among Tahfiz students. This cross-sectional pilot study was conducted in 2022. The first phase entailed developing the KAP questionnaires. The second phase involved determining the content validity and face validity. While the third phase involved evaluating the reliability. A total of six experts from public academic institutions participated in the initial evaluation stage to assess validity while five experts were involved in the second stage. Thirty-three and 41 respondents were involved for the face validity and reliability evaluation, respectively. The questionnaires were distributed via Google Docs and hard copies were handed out in person to Tahfiz school teachers and students at Madrasah Tahfiz Al-Amani and Pondok Moden Tahfiz Saadah Addaarain. The findings demonstrated that the Item Content Validity Index (I-CVI) for the three components of the KAP questionnaires at the second stage of evaluation was high (1.0). The scores for the Scale Face Validity Average Index (S-FVI/Average) in assessing the level of clarity and understanding for the three components were 0.89 and 0.88, 0.92 and 0.90, and 0.88 and 0.9, respectively. Meanwhile, the reliability of KAP for physical activity was moderate (0.43), very high (0.91) and high (0.7), respectively. For nutrition, the reliability of KAP was good and acceptable with the values of 0.63, 0.83 and 0.65, respectively. The results of reliability of KAP for psychological well-being was good with the values of 0.54, 0.56 and 0.84, respectively. The KAP questionnaires of e-Huffaz ProHealth was successfully developed with high content validity, good face validity and acceptable reliability. Hence, it can be used for future study to evaluate the effectiveness of e-Huffaz ProHealth among Tahfiz students.

Development of self-administered questionnaire on barriers, prescription practices, and guideline adherence of osteoporosis management among tertiary care clinicians: content validity and reliability analysis

Objective

This study outlined the development of the barriers, prescribing practices, and guideline adherence for osteoporosis management according to the Clinicians' Osteoporosis Questionnaire (COQ) followed by an assessment of the content validity index and reliability test.

Methods

The development of the COQ was performed in two stages. Stage I involved the development of the COQ, and stage II involved judgmental evidence and quantification of the questionnaire. Five panel experts related to the study area and five clinicians participated in the validity of the COQ assessment. Fifty clinicians took part in the reliability test evaluation by filling out the questionnaire twice at 2-week intervals. The content validity index (CVI) and content validity ratio (CVR) were analyzed using Microsoft Excel, while Cohen's kappa statistic was used to determine the test-retest reliability using SPSS version 29.

Results

Forty items and three domains, namely, barriers, prescribing practices, and guideline adherence for osteoporosis management, were identified in the COQ (version 4.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVRs for all the items were above 0.7, except for two items in the barrier domain and two items in the guideline adherence domain. Two items were revised to improve the clarity of the item, and other items were retained based on consensus among the expert panel. Between the test and retest, the reliability of individual items ranged from moderate to almost perfect for the barrier domain (k = 0.42-0.86), prescribing practice domain (k = 0.79-0.87), and guideline adherence domain (k = 0.46-1). None of the items had "fair" or "poor" agreement. Thus, the 40-item COQ (version 4.0) was finalized following the content and face validity analysis.

Conclusions

Through an iterative process, the development and assessment of the COQ showed a high degree of content validity and reliability in measuring the barriers, prescribing practices, and guideline adherence among clinicians managing osteoporosis. Future studies should aim to further validate this instrument across different populations and settings, as well as explore methods to enhance its reliability and validity.

Knowledge and practices of plagiarism among journal editors of Nepal

BACKGROUND

This study was conducted to assess the knowledge and ongoing practices of plagiarism among the journal editors of Nepal.

METHODS

This web-based questionnaire analytical cross-sectional was conducted among journal editors working across various journals in Nepal. All journal editors from NepJOL-indexed journals in Nepal who provided e-consent were included in the study using a convenience sampling technique. A final set of questionnaires was prepared using Google Forms, including six knowledge questions, three practice questions (with subsets) for authors, and four (with subsets) for editors. These were distributed to journal editors in Nepal via email, Facebook Messenger, Viber, and WhatsApp. Reminders were sent weekly, up to three times. Data analysis was done in R software. Frequencies and percentages were calculated for the demographic variables, correct responses regarding knowledge, and practices related to plagiarism. Independent t-test and one-way ANOVA were used to compare mean knowledge with demographic variables. For all tests, statistical significance was set at p < 0.05.

RESULTS

A total of 147 participants completed the survey.The mean age of the participants was found to be 43.61 ± 8.91 years. Nearly all participants were aware of plagiarism, and most had heard of both Turnitin and iThenticate. Slightly more than three-fourths correctly identified that citation and referencing can avoid plagiarism. The overall mean knowledge score was 5.32 ± 0.99, with no significant differences across demographic variables. As authors, 4% admitted to copying sections of others' work without acknowledgment and reusing their own published work without proper citations. Just over one-fifth did not use plagiarism detection software when writing research articles. Fewer than half reported that their journals used authentic plagiarism detection software. Four-fifths of them suspected plagiarism in the manuscripts assigned through their journal. Three out of every five participants reported the plagiarism used in the manuscript to the respective authors. Nearly all participants believe every journal must have plagiarism-detection software.

CONCLUSIONS

Although journal editors' knowledge and practices regarding plagiarism appear to be high, they are still not satisfactory. It is strongly recommended to use authentic plagiarism detection software by the journals and editors should be adequately trained and update their knowledge about it.

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.

Face and content validity of a holistic assessment questionnaire to assess cancer-related fatigue after breast cancer

Background and objective

Cancer-related fatigue (CRF) affects the quality of life after breast cancer. In a previous study, we developed a 72-item questionnaire that assesses CRF from a holistic point of view; named the Holistic Assessment of CRF (HA-CRF) questionnaire. The current study assessed the face and content validity of the HA-CRF questionnaire.

Methods

Using a mixed-method approach, ten breast cancer survivors (BCS) did a cognitive walkthrough of the HA-CRF via an app followed by a semi-structured interview about relevancy and essentiality (qualitative). In addition, ten health care professionals (HCPs) assessed the relevancy, clarity, and essentiality of each item via a questionnaire (quantitative).

Results

BCS indicated minor textual improvement for four items and six items were not completely clear. The app was considered easy to use and the HC-CRF was on average completed in 18 minutes. The HA-CRF questionnaire provided openness about fatigue and gave the feeling of being heard. The items were helpful and induced self-awareness. HCPs indicated 71% of items being very clear or minor revisions proposed by the minority, with 64% of items being essential and 92% considered relevant.

Conclusions

The HA-CRF showed good face and excellent content validity. Further research is needed to assess its ability to monitor in daily life.

Validation of a Questionnaire to Assess Patient Satisfaction with an Automated Drug Dispensing System

BACKGROUND AND OBJECTIVES

Automated drug dispensing systems (ADDs) have been introduced to improve the efficiency of dispensing and patient safety. The available questionnaires measure patient satisfaction with particular aspects of ADDs. Also, the level of patient satisfaction with ADDs is not widely established. This study aimed to develop and validate a novel questionnaire to assess patient satisfaction with ADDs.

METHODS

Content and construct validity procedures were used to validate the 20-item questionnaire with four domains, including pharmacy administration, dispensing practice, patient education, and the dispensing system. Two hundred consenting participants took part in this study, from those who visited the outpatient pharmacy in a government hospital.

RESULTS

The internal consistency of all four scale items shows acceptable reliability (>0.7). In the exploratory factor analysis, three items were removed due to poor factor loading and cross-loading. In the confirmatory factor analysis, the model has acceptable fit indices, including the comparative fit index (0.937), Tucker-Lewis's index (0.924), standardized root mean square residual (0.051), root mean square error of approximation (0.057), and χ2/df (1.67). The convergent and discriminant validity were established, since the average variance extracted (AVE) was ≥0.5 and the squared correlation (SC) values of one construct with other constructs were less than the AVE of the specific construct.

CONCLUSION

This study offered a reliable and valid 17-item questionnaire incorporating a multi-dimensional four-factor model to evaluate patient satisfaction with ADDs. The validated questionnaire can be utilized to explore patients' perspectives on ADDs.

Cadaveric Biomechanical Laboratory Research Can Be Quantitatively Scored for Quality With the Biomechanics Objective Basic Science Quality Assessment Tool: The BOBQAT Score

PURPOSE

To develop a quality appraisal tool for the assessment of cadaveric biomechanical laboratory and other basic science biomechanical studies.

METHODS

For item identification and development, a systematic review of the literature was performed. The content validity index (CVI) was used either to include or exclude items. The content validity ratio (CVR) was used to determine content validity. Weighting was performed by each panel member; the final weight was either up- or downgraded to the closest of 5% or 10%. Face validity was scored on a Likert scale ranked from 1 to 7. Test-retest reliability was determined using the Fleiss kappa coefficient. Internal consistency was assessed with Cronbach's alpha. Concurrent criterion validity was assessed against the Quality Appraisal for Cadaveric Studies scale.

RESULTS

The final Biomechanics Objective Basic science Quality Assessment Tool (BOBQAT) score included 15 items and was shown to be valid, reliable, and consistent. Five items had a CVI of 1.0; 10 items had a CVI of 0.875. For weighting, 5 items received a weight of 10%, and 10 items a weight of 5%. CVR was 1.0 for 6 items and 0.75 for 9 items. For face validity, all items achieved a score above 5. For test-retest reliability, almost-perfect test-retest reliability was observed for 10 items, substantial agreement for 4 items, and moderate agreement for 1 item. For internal consistency, Cronbach's alpha was calculated to be 0.71. For concurrent criterion validity, Pearson's product-moment correlation was 0.56 (95% confidence interval [CI] = 0.38-0.70, P = .0001).

CONCLUSIONS

Cadaveric biomechanical and laboratory research can be quantitatively scored for quality based on the inclusion of a clear and answerable purpose, demographics, specimen condition, appropriate bone density, reproducible technique, appropriate outcome measures, appropriate loading conditions, appropriate load magnitude, cyclic loading, sample size calculation, proper statistical analysis, results consistent with methods, limitations considered, conclusions based on results, and disclosure of funding and potential conflicts.

CLINICAL RELEVANCE

Study quality assessments are important to evaluate internal and external validity and reliability and to identify methodological flaws and misleading conclusions. The BOBQAT score will help not only in the critical appraisal of cadaveric biomechanical studies but also in guiding the designs of such research endeavors.

Development and Validation of Knowledge Attitudes and Practices Questionnaire (Nu-KAPQ): for the assessment of Knowledge, Attitudes, and Practices Associated with Arsenic

More than 70 million individuals have been exposed to environmental arsenic toxicity, worldwide. United Nation Children's Fund (UNICEF) policy brief -2018 report to mitigate arsenic in drinking water, emphasizes assessing, and changing the knowledge, attitudes, and practices (KAP) as one of the long-term effective solutions to be implemented as a part of surveillance strategies. This study aims to develop a valid and reliable tool to assess knowledge, attitude, and practices of arsenic and its risk in general health. A cross-sectional survey of N=449 general population was conducted in the outpatient department of Rajendra Memorial Research Institute of Medical Sciences-Indian Council for Medical Research for data collection. The construct validation of the questionnaire was done using Exploratory Factor Analysis, Confirmatory factor analysis. The Item-Content Validity Index(I-CVI) and Scale-Content Validity Index (S-CVI) Kappa scores were used to analyze the content validity of the items. The I-CVI ranges from 0.70 to 1, the and the moderate to high cumulative content validity is S-CVI/Universal Agreement=0.84; S-CVI/Average =0.96. Following the principal component analysis, the cumulative Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) was 0.91 and the three domains in the tool (Kaiser-Meyer-Olkin measure of sampling adequacy for Knowledge (0.917), Attitude (0.825) & Practices (0.80)) were within the acceptable range. The Barret's test for sphericity was (P <0.001) and was highly acceptable. The Confirmatory Factor Analysis model of Nu-KAP has demonstrated excellent model fit where, majority of fit indices has sown good fit (X2/df=1.88, Root Mean Square Error of Approximation = 0.04, Comparative Fit Index=0.98, Goodness of Fit Index = 0.93, and Tucker Lewis Index=0.977). The Cronbach's alpha of 19 item tool was 0.72. The Nu-KAPQ questionnaire demonstrated exceptional validity and reliability while also capturing and integrating all pertinent psychometric analytic domains. Conclusively, this questionnaire can be used to assess psychometric properties associated with arsenic bridging the gap in current research to understand people's perception towards arsenic, since it is a crucial component of arsenic mitigation.

Evaluating attitudes toward soft drink consumption among adults in Saudi Arabia: Five years after selective taxation implementation

Objective

Saudi Arabia (SA) ranked first in soft drink consumption in the Middle East. A decrease in consumption was recorded after a selective 50% increased taxation policy in 2018. This study aimed to assess soft drinks consumption patterns among Saudi Arabian adults and examine the association between different attitudes and patterns post-taxation.

Methods

This cross-sectional study was conducted from October 2022 to March 2023, involving 1,935 Saudi adults aged 20-60 residing in Saudi Arabia. Participants completed online surveys using a validated questionnaire assessing sociodemographic characteristics, soft drink consumption patterns, and attitudes toward soft drinks. Chi-square and odds ratio (OR) tests were used to assess associations between sociodemographic characteristics, soft drink consumption frequency/quantity, and change in consumption patterns owing to selective taxation. Additionally, t-tests, Spearman's coefficient, and hierarchical multiple linear regression were used to measure differences in attitudes and linear relationships.

Results

Overall, 7.5% of the participants reported daily soft drink consumption, with 51.8% of these consuming less than one can per day and 41.2% consuming one can per day. Most (66.2%) reported no change in consumption post-taxation. Attitudes toward soft drink consumption varied significantly, with most agreeing on its health risks but also enjoying the drinks. Multiple regression analysis identified age, education, income, consumption frequency/quantity, and impact of taxation as significant predictors of overall attitudes toward soft drinks.

Conclusions

After taxation, 20% of participants reduced soft drink consumption, underscoring the importance of addressing taxation and intrinsic motivations to foster lasting changes in attitudes and behaviors towards soft drinks.

Migraine symptoms and association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis among university students in Peninsular Malaysia: A cross-sectional study

Introduction

Differentiating between migraine and COVID-19 headaches is essential for better treatment. Evidence-based research during the COVID-19 pandemic has found that university students are more likely to experience migraine. Migraine can affect academic performance, sleep pattern, social and emotional well-being if left untreated or misdiagnosed. This study aimed to determine the prevalence of migraine symptoms and the association of triggers, coping strategies and clinical characteristics with COVID-19 diagnosis.

Methods

This cross-sectional study was conducted across higher educational institutions in Peninsular Malaysia. Convenience sampling was applied to recruit full-time university students. A reliable and validated instrument was used to evaluate demographic data, migraine symptoms, triggers, coping strategies and clinical characteristics of migraine (frequency, intensity, severity and duration) during COVID-19 diagnosis.

Results

The response rate was 98.3%, where 485 out of 493 responses were analysed. The prevalence of migraine was 35.9% (n=174). None of the triggers, coping strategies and clinical characteristics of migraine were significantly associated with COVID-19 diagnosis.

Conclusion

The university students in Peninsular Malaysia showed a considerable prevalence of migraine symptoms. During the pandemic, the common triggers for existing symptoms were stress and a lack of sleep (combined triggers). The coping strategy adopted by most of the university students was lifestyle changes and in the COVID-19 positive group maladaptive coping strategies were adopted indicating the need for further investigation.

Neuromyelitis optica spectrum disorders registry system in Iran: Validity of data sets

BACKGROUND

A targeted structure for recording, monitoring, and follow-up of patients with neuromyelitis optica spectrum disorders (NMOSD) is in demand. To obtain the correct and uniform standardized information registry system, it is necessary to use a data set that has good validity to help policy-makers systematically plan for improvements in the quality of care. The main goal of the present study was to develop a NMOSD data set for the national registry system in Iran (NMORI) and to evaluate the validity of the presented data set.

METHODS

The NMORI data set consisted of baseline characteristics, disease and exposure history, background and past medical history, diagnosis and treatment, clinical features, imaging, and para-clinical findings. The content validity was evaluated by 18 experts from Iran, Japan, and Denmark by scoring each of the questionnaire items in term of transparency, simplicity, and relevance. According to the points given, the content validity index (CVI) and content validity ratio (CVR) scores were calculated and compared with the critical limit.

RESULTS

The current study was designed as a 125-items data set which was considered valid. In terms of relevance 110 out of 125 items, simplicity 113 out of 125 items, and transparency 123 out of 125 items had Item-CVI>0.79. All Scale-level-CVI values were greater than 0.9, showing noticeable content validity. In this data set, 112 items had CVR > 0.49, which was considered an acceptable level of significance.

CONCLUSION

The implementing of NMORI is important in a developing country such as Iran with significant increasing prevalence of this disease. This registry facilitates a uniform and valid diagnosis and is considered valid for clinical investigation and epidemiological research on NMOSD. Scientists and healthcare policymakers can rely on a validated data set in order to have access to accurate data.

Psychometric properties of the Turkish version of the eating in the absence of hunger in children and adolescents (EAH-C)

BACKGROUND AND PURPOSE

Eating in the absence of hunger is a risk factor for excessive energy intake and predisposes children to overweight/obesity. The purpose of this study was to test the validity and reliability of the "Eating in the Absence of Hunger Questionnaire for Children and Adolescents (EAH-C)" in Türkiye.

METHODS

This study was conducted in a total of six schools, with children 8-18 years old between September and December 2022. Factor analysis, item-total score analysis and Cronbach's alpha coefficient were used for the validity and reliability.

RESULTS

The calculated KMO statistic was >0.60, and the Bartlett's test statistic was <0.05. The three subscales accounted for 65.22% of the total variance. Factor loads ranged from 0.41 to 0.84. The value obtained by dividing χ2 by the number of degrees of freedom was <5; the RMSEA was <0.10; the RMR was <0.08; and the TLI, GFI, AGFI, and CFI were >0.90. Cronbach's alpha coefficient was 0.91 for the total scale.

CONCLUSIONS

Our study has confirmed that the Turkish-language version of the EAH-C is a valid and reliable tool.

PRACTICE IMPLICATIONS

In the effort of prevention of childhood obesity, identifying eating behaviors in the absence of hunger in children and adolescents will benefit policymakers to develop intervention and prevention programs, in addition to providing guidance to pediatric nurses, all healthcare professionals, researchers, children, and parents.

Intensive care unit dignified care: Persian translation and psychometric evaluation

AIM

The present study aimed to evaluate the psychometric properties of the Persian version of the 'Intensive Care Unit Dignified Care Questionnaire (IDCQ)' among Iranian nurses.

DESIGN

A methodological and psychometric study was conducted in 2022, involving nurses from six teaching hospitals in Kermanshah, Western Iran.

METHODS

The IDCQ was translated into Persian using a forward-backward translation method. Construct validity was assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), employing a stratified sampling method with 455 critical care nurses. Internal consistency was gauged using Cronbach's alpha coefficient, while reliability was determined through the test-retest method. Analyses were performed using SPSS version 26 and Lisrel version 8 software.

RESULTS

EFA and CFA validated the instrument's two-factor, 17-item structure. The CFA indicated a well-fitting model with fit indices: CFI = 0.93, NNFI = 0.92, GFI = 0.861, RMSEA = 0.051 and SRMR = 0.046. Pearson's correlation coefficient substantiated a significant relationship between the items, subscales and the overall scale. The instrument's reliability was confirmed by a Cronbach's α coefficient of 0.88 and a test-retest reliability of 0.86.

CONCLUSION

The Persian version of the IDCQ, comprising two factors and 17 items, has been validated as a reliable and applicable tool for use within the Iranian nursing community.

Assessing Heart Failure Self-management Knowledge Through Vignettes

BACKGROUND

Heart failure (HF) self-care is key to managing symptoms, but current HF knowledge instruments are at risk for social desirability bias (ie, tendency to respond in a way that is viewed favorably). Vignettes may be a useful method to mitigate this bias by measuring knowledge via scenarios in which individuals with HF are invited to respond to fictional characters' self-management problems rather than disclosing their own practices.

OBJECTIVE

The aims of the study were to develop and test the content validity of vignettes measuring individuals' knowledge of HF symptom self-management.

METHODS

The study had 3 phases. In phase 1, two vignettes were developed. One focused on psychological symptom self-management (ie, anxiety, depression), and the other focused on physical symptom self-management (ie, edema, fatigue). In phase 2, the research team and lay experts made improvements to the vignettes' readability. In phase 3, five HF self-care nurse experts evaluated the vignettes' clarity and importance with a 3-point Likert-type scale using Delphi methods. We calculated the vignettes' content validity using the scale-level content validity index.

RESULTS

The final content validation encompassed 2 Delphi rounds (phase 3), yielding a scale-level content validity index of 0.92 and 0.94 for the psychological and physical symptom vignettes, respectively. These results indicate excellent initial content validity.

CONCLUSIONS

The content of vignettes measuring individuals' knowledge of HF symptom self-management is valid based on the opinions of nurse experts. The vignettes offer a promising method to assess knowledge about HF self-care management without the pressure of disclosing individual patient practices.

Leveraging Large Language Models in the delivery of post-operative dental care: a comparison between an embedded GPT model and ChatGPT

OBJECTIVE

This study underscores the transformative role of Artificial Intelligence (AI) in healthcare, particularly the promising applications of Large Language Models (LLMs) in the delivery of post-operative dental care. The aim is to evaluate the performance of an embedded GPT model and its comparison with ChatGPT-3.5 turbo. The assessment focuses on aspects like response accuracy, clarity, relevance, and up-to-date knowledge in addressing patient concerns and facilitating informed decision-making.

MATERIAL AND METHODS

An embedded GPT model, employing GPT-3.5-16k, was crafted via GPT-trainer to answer postoperative questions in four dental specialties including Operative Dentistry & Endodontics, Periodontics, Oral & Maxillofacial Surgery, and Prosthodontics. The generated responses were validated by thirty-six dental experts, nine from each specialty, employing a Likert scale, providing comprehensive insights into the embedded GPT model's performance and its comparison with GPT3.5 turbo. For content validation, a quantitative Content Validity Index (CVI) was used. The CVI was calculated both at the item level (I-CVI) and scale level (S-CVI/Ave). To adjust I-CVI for chance agreement, a modified kappa statistic (K*) was computed.

RESULTS

The overall content validity of responses generated via embedded GPT model and ChatGPT was 65.62% and 61.87% respectively. Moreover, the embedded GPT model revealed a superior performance surpassing ChatGPT with an accuracy of 62.5% and clarity of 72.5%. In contrast, the responses generated via ChatGPT achieved slightly lower scores, with an accuracy of 52.5% and clarity of 67.5%. However, both models performed equally well in terms of relevance and up-to-date knowledge.

CONCLUSION

In conclusion, embedded GPT model showed better results as compared to ChatGPT in providing post-operative dental care emphasizing the benefits of embedding and prompt engineering, paving the way for future advancements in healthcare applications.

Development of an epilepsy self-management mobile health app framework: Content validity study results

BACKGROUND

Mobile health (mHealth) applications (apps) show promise in supporting epilepsy self-management (eSM). To delve deeper into this potential, we conducted a systematic review of epilepsy mHealth apps available on both iOS and Android platforms, examining articles related to eSM. This review allowed us to identify important domains related to eSM. Furthermore, based on the findings, we developed an epilepsy mHealth app framework that aims to improve self-management for the local population. This study aims to assess the practicality and usability of the proposed mHealth app framework designed to improve eSM. We will conduct an expert panel review to evaluate the effectiveness and feasibility of the framework.

MATERIAL AND METHODS

Content validity was assessed by an expert panel comprising epileptologists and pharmacists. The validation process involved scoring the items within each domain of the framework to evaluate their practicality and usability (quantitative component). In addition, a panel discussion was conducted to further explore and discuss the qualitative aspects of the items.

RESULTS

A total of 4 domains with 15 items were highly rated for their practicality and usefulness in eSM.

CONCLUSIONS

The locally validated framework will be useful for developing eSM mobile apps. Seizure Tracking, Medication Adherence, Treatment Management, and Healthcare Communication emerged as the most crucial domains for enhancing eSM.

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

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

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

BACKGROUND

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

AIM

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

METHOD

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

RESULTS

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

CONCLUSION

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

Development and validation of a health practitioner survey on ocular allergy

Survey studies have played a significant role in understanding the gaps in the knowledge and practices of health practitioners. However, there have been no such survey studies on Ocular Allergy (OA). Thus, the purpose of this study was to develop and validate a survey on OA to better understand the gaps in the diagnostic, treatment, and collaborative care approaches of health practitioners in OA. The survey is titled "Survey on Ocular Allergy for Health Practitioners (SOAHP)". SOAHP was developed in a five-stage process. First, item extraction via the use of a literature review, second, face and content validity, third, a pilot study, fourth, test-retest reliability, and fifth, finalisation of the survey. 65 items under 6 domains were initially generated in the item extraction phase. Content validity was conducted on 15 experts in the field. This was conducted twice to reach consensus whereby items and domains were added, edited, kept, or removed, resulting in 50 items under 7 domains. The pilot study was conducted on 15 participants from the five relevant health practitioner fields (Allergists/Immunologists, General Practitioners (GPs), Ophthalmologists, Optometrists and Pharmacists). This altered the survey further to 40 items under 7 domains. Test-retest reliability was conducted on 25 participants from the five health practitioner fields. Reliability was moderate to almost perfect for most (97%) investigated items. The finalised survey was 40 items under 7 domains. SOAHP is the first survey created to assess diagnostic, treatment and collaborative care approaches of Allergists/Immunologists, GPs, Ophthalmologists, Optometrists and Pharmacists on OA. SOAHP will be a useful tool in clinical research on OA.

Downloading appetite? Investigating the role of parasocial relationship with favorite social media food influencer in followers' disordered eating behaviors

PURPOSE

Although a number of investigations have been carried out on the marketing outcomes of parasocial relationships (PSR) with food influencers on social media, little attention has been paid to the potential contribution of these one-sided emotional bonds to followers' eating attitudes and habits. Drawing on the Parasocial Theory, the role of parasocial attachment with food influencers was investigated in predicting eating disorders, food addiction, and grazing. To increase the accuracy of PSR measurement, a brief self-report scale was developed to gauge social media users' feelings of mutual awareness, attention, and adjustment with their favorite food influencer at a distance through social media.

METHODS

Participants were a convenience sample of 405 Iranian social media users (231women; Mage = 28.16, SDage = 9.40), who followed a favorite food influencer on social media.

RESULTS

The 8-item Parasocial Relationship with Favorite Food Influencer Scale (PSRFFIS) revealed a unidimensional structure with excellent content and construct validity and internal consistency. Regarding gender differences, men showed stronger parasocial attachment to their favorite food influencers. Adjusting age, gender, and subjective social status as control variables, PSR with favorite food influencers partially contributed to the explanation of eating disorder symptom severity, food addiction, and grazing.

CONCLUSION

These findings show that PSR with favorite food influencers appears to be associated with followers' craving for food, which, in turn, may contribute to maladaptive eating habits. This highlights media-related factors, such as PSR with food influencers, as potential drivers of dysfunctional eating habits in the digital age, particularly in countries like Iran where disordered eating is prevalent.

LEVEL OF EVIDENCE

Level V-based on cross-sectional data (correlational study; scale development).

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

OBJECTIVE

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

DESIGN

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

SETTING

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

MEASUREMENTS

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

RESULTS

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

CONCLUSION

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

Translation and cross-cultural adaptation of the Spanish version of the King's Parkinson's Disease Pain Scale (KPPS)

PURPOSE

To translate and cross-culturally adapt the King's Parkinson's Disease Pain Scale (KPPS) into Spanish.

METHODS

The English KPPS was forward translated into Spanish, back translated, and revised by the original developers. Cross-cultural adaptation of relevant target groups was conducted following COSMIN standards. Cognitive pretesting in Spanish people with Parkinson's Disease (PD) and pain was performed via three semi-structured focus group meetings. Changes were implemented based on qualitative and quantitative analyses. A Delphi study (two rounds) of individual assessments by Spanish experts was conducted. Changes were implemented based on the Content Validity Index (CVI) at item and scale levels (I-CVI/S-CVI).

RESULTS

Five Spanish professionals performed the initial translation. Thirty-eight inter-translation inconsistencies were identified, and consensus was reached for a unified version. After back translation and confirmation with scale developers, the pre-final Spanish KPPS was obtained. Cognitive pretesting in 30 people with PD-related pain identified 5 items where terminology changes were made to assure comprehensibility. The Delphi study in 14 Spanish experts underlined the necessity to further modify two items. After the second round, all experts agreed on the modifications and I-CVI and S-CVI were satisfactory.

CONCLUSIONS

The KPPS was successfully translated and cross-culturally adapted into Spanish.

Translation, cultural adaptation and assessment of psychometrics properties of the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) in Persian language speaking people

BACKGROUND

To translate and cross-culturally adapt the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) into Persian (NMQ-E-P) and evaluate the psychometric properties in a general population with different occupational tasks across nine body regions.

METHODS

This cross-sectional study was designed according to the standard guidelines and the COSMIN checklist. The NMQ-E-P was achieved through forward and backward translation methods and consensus to produce the final draft. A Persian-speaking population (n = 571, age 38.24 ± 7.65 years, female = 46.2%) was recruited from industries and office workers with three occupational task inclusion criteria: assembly, office, and lifting. Psychometric properties included validity for face (from confirmed clarity, simplicity, and readability), content (via the content validity index); and construct (through known group validity); additionally, the properties of internal consistency (Cronbach's α); and test-retest reliability (Kappa coefficient of agreement) were considered.

RESULTS

No significant issues during the translation process were found. The NMQ-E-P showed adequate internal consistency for all regions (α ≥ 0.87). The test-retest reliability was examined with Kappa agreement correlation coefficient and all items, except ankle regions, showed very good agreements (Kappa coefficient = 0.87-1.0). Excellent ICC values were obtained for quantitative variables (ICC > 0.88) and good construct validity was revealed (p < 0.001).

CONCLUSION

The Persian version of the NMQ-E has very good validity and reliability and can be used by researchers and professionals to evaluate the prevalence of MSDs in nine body regions simultaneously.

Structured Multidisciplinary work Evaluation Tool (SMET) questionnaire: Translation, cultural adaptation and psychometric evaluation of the Persian version

BACKGROUND

To assess relevant environmental conditions in any work-setting requires a multidisciplinary perspective that is practical, valid, and reliable. This includes the physical, environmental, and psychosocial risk-factors. The Structured Multidisciplinary work Evaluation Tool (SMET) questionnaire simultaneously considers multiple work-related demands.

OBJECTIVE

This study translated and culturally adapted the SMET into Persian and evaluated its psychometric properties in Persian industrial workers.

METHODS

Cross-sectional translation and cross-cultural adaptation in five standardized phases. A convenience sample (n = 211) recruited from an industrial-occupation setting completed: the SMET; and the Rapid Upper Limb Assessment (RULA), and National Aeronautics and Space Administration Task Load Index (NASA-TLX) criteria; plus light and noise levels were concurrently assessed. Psychometric properties included: validity, with face (from confirmed language clarity, simplicity, and readability), content (via the content validity index, CVI, for equivalency and relevancy), criterion (through Pearson's r correlation with relevant criteria), and construct (through known group validity between participants with/without work-related musculoskeletal disorders, WMSDs); internal consistency (Cronbach's α); and test-retest reliability (intraclass correlation coefficient, ICC2.1).

RESULTS

Validity was confirmed with: face through the adaptation; content from suitable CVI values for items (CVI range = 0.78-1.0) and scale-total (CVI = 0.86); criterion from SMET associations with levels for light (r = - 0.42) and noise (r = 0.21), plus RULA (r = 0.42) and NASA-TLX (r = 0.39); and construct through participants with WMSD having significantly higher SMET total-scores (p = 0.01). Internal consistency (α= 0.89) and reliability (ICC2.1 = 0.87) were acceptable and strong.

CONCLUSION

This study indicated that the SMET Persian version had acceptable psychometric properties in an industrial occupational setting. Further investigation in longitudinal populations is recommended.

Development and Content Validation of a Measure to Assess the Parent-Child Social-emotional Reciprocity of Children with ASD

Background

As no scales are currently available to assess the social-emotional reciprocity (SER) between children with autism spectrum disorder (ASD) and their parents, we aimed to develop a questionnaire for this.

Methods

Both quantitative and qualitative techniques were used for content validation. All stages of this study used purposive sampling to choose various groups of experts, mental health professionals, and parents of children with ASD to participate in the development, judgment-quantifying, and pretest stages. Data from 30 parents of children with ASD were gathered for the field test.

Results

Thirty items were retained after content validation. The proportion of consensus regarding the comprehensiveness of the entire questionnaire was 1.00. The scale-level content validity index (CVI) by averaging calculation method and universal agreement calculation method were 0.95 and 0.50, respectively. Following the pretest, a total of 23 questions, on a five-point scale, were retained.

Conclusion

Given the significance of SER between children with ASD and their parents, mental health practitioners should use this questionnaire to understand it to maximize the efficacy of any intervention.

Content Validity Testing of a Novel Cognitive Screen, the Gaylord Occupational Therapy Cognitive (GOT-Cog), to Improve Inpatient Occupational Therapy Treatment Planning

IMPORTANCE

No single cognitive screen adequately captures all cognitive domains that are important for inpatient occupational therapy treatment planning.

OBJECTIVE

To quantify the content validity of a novel 22-item cognitive screen, the Gaylord Occupational Therapy Cognitive (GOT-Cog) screen, developed to better inform inpatient occupational therapy treatment planning.

DESIGN

Delphi-style expert panel review.

SETTING

Long-term acute care hospital.

PARTICIPANTS

The first panel was attended by four occupational therapists, two speech-language pathologists, one physician assistant, and two neuropsychologists; the second, by four occupational therapists, one speech-language pathologist, and one physician assistant.

INTERVENTION

Each Delphi panel discussed the relevance, essentiality, and clarity of each item. After each discussion, panelists completed a content validity survey to summarize their evaluation of each item.

OUTCOMES AND MEASURES

On the basis of panelists' survey responses, item- and scale-level relevance, essentiality, and clarity were quantified by calculating the respective content validity index (CVI), content validity ratio (CVR), and content clarity index (CCI). Universal agreement (UA) and κ statistics were also calculated, as appropriate.

RESULTS

Upon presenting the initial 23-item instrument covering 10 cognitive domains to the first Delphi panel, several questions were added, removed, or rewritten, resulting in a 22-item instrument representing nine domains. After the second panel, several questions were again rewritten, and the domains reorganized. All scale-level metrics improved, including CVI (from 0.87 to 1.0), UA (0.52 to 1.0), CVR (0.43 to 0.94), and CCI (2.26 to 2.92).

CONCLUSIONS AND RELEVANCE

GOT-Cog displays overall excellent content validity and can proceed to construct validity testing. Plain-Language Summary: By reporting on the content validity of the Gaylord Occupational Therapy Cognitive screen, this brief report begins the necessary process of evaluating the measure's overall validity and reliability.

Development and validation of self-report Mizaj identification questionnaire Based on Persian Medicine for the elders (age over 60)

Background

Introduction: Mizaj is the basis of attention to individual differences in Persian Medicine (PM). Regarding the importance of Mizaj for health preservation and treating diseases, it is necessary to achieve a standard tool for Mizaj identification. The purpose of this study was to design a standard self-reporting Mizaj identification questionnaire for elders.

Methods

In this exploratory sequential study, criteria of Mizaj identification were extracted by reviewing PM literatures and interview with PM experts and elders. The primary questionnaire was designed and its validity and reliability were assessed, using weighted Kappa statistics, Pearson correlation coefficient (PCC) assessment, receiver operating characteristic (ROC) curve and determining the specificity and sensitivity of cut-off points.

Results

Among the 101 items in the primary questionnaire, 73 items had acceptable reliability. The final 20-item questionnaire was obtained after the criterion validity and PCC assessment. The sensitivity and specificity of this questionnaire were 83% and 88% for warmness, 49% and 80% for moderate in warmness-coldness, 72% and 91% for coldness, 57% and 78% for wetness, 30% and 79% for moderate in wetness-dryness, and 81% and 67% for dryness, respectively.

Conclusion

The standard Mizaj identification is recommended as a supplementary diagnostic tool for clinicians and researchers in PM. Also, the people with age over 60 can use it to identify their own Mizaj and then, choose the suitable PM or Unani medicine lifestyle recommendations based on their Mizaj.

Development and validation of informed consent for blood transfusion questionnaire

INTRODUCTION

Blood transfusion warrants written informed consent from the patient. However, patients have poor knowledge regarding blood transfusions as evidenced by nonstandardized information retained by patients from the informed consent discussion. The problem stems from suboptimal patient knowledge on the elements of informed consent. This study describes the development and validation of a new questionnaire to assess the knowledge on informed consent for blood transfusion from the patients' perspective.

SUBJECTS AND METHODS

The development phase consisted of literature review, small group discussion, expert review meeting, content, and face validity. We evaluated the psychometric properties of Informed Consent for Blood Transfusion Questionnaire (ICBTQ) using reliability test and item response theory among a sample of 95 patients in Hospital Universiti Sains Malaysia.

RESULTS

ICBTQ was formulated to include sociodemographic and knowledge sections. ICBTQ possessed excellent content validity. The face validity index (FVI) of clarity and comprehension were both 0.97. Thus, the universal FVI was 0.96. One item was added following the advice given by one of the content experts. ICBTQ had excellent face validity. For the validation phase, ICBTQ demonstrated an acceptable Cronbach's Alpha value. One item was omitted in view of low corrected item-total correlation. In the item response theory (IRT) analysis, ICBTQ exhibited good difficulty and discriminatory indexes. Assessments of item-fit indicated that all items of the model were well-fitted.

CONCLUSIONS

Based on the IRT and reliability analysis, the knowledge section of the ICBTQ was psychometrically valid to be used among patients.

Translation, and validation of Dysphagia Outcome and Severity Scale (DOSS): Swedish version

BACKGROUND

Swallowing dysfunction (dysphagia) significantly impacts patient and medical outcomes. In Sweden, there is no comprehensive outcome measure for dysphagia that incorporates holistic assessment and dysphagia impact on a person's impairment, function and participation. The Dysphagia Outcome and Severity Scale (DOSS) was developed and validated (in English) and incorporates the World Health Organisation's (WHO) aforementioned, International Classification of Functioning (ICF) aspects. This study translated then evaluated the validity and reliability of the Swedish version, DOSS-S.

METHOD

Translation occurred based on WHO recommendations. The Content Validity Index (CVI) of the translated version (DOSS-S) was assessed twice by 11 (multi-professional) dysphagia experts. Criterion validity and rater reliability was calculated using 18 Speech Pathologists assessing patient cases from International Dysphagia Diet Standardization Initiative-Functional Diet Scale (IDDS-FDS) research.

RESULTS

Very high CVI values (0.96-0.99) for the linguistic correlation, and high CVI values (0.84-0.94) for applicability correlation were achieved. High criterion validity of DOSS-S with IDDSI-FDS was demonstrated (rs = 0.89, p < 0.01), with very high inter and intra rater reliabilities (ICC > 0.90).

CONCLUSION

The DOSS-S demonstrated very high validity values, and very high inter and intra rater reliability. This research contributes to improved dysphagia management by providing interprofessional dysphagia clinicians with a validated scale to identify patient progression, communicate dysphagia status between regions and countries, and document patient outcomes using an ICF framework.

Health Education for Chronic Kidney Disease Patients Not on Dialysis Through the Pictorial Patient Information Leaflet

Background: Educating the patient with patient information leaflets is helpful to increase understanding and awareness about chronic kidney disease. Various educational materials are available online, but their quality is mixed. The content was found to be unreliable or incomprehensible. Objective: The study aimed to develop, validate, test the readability, translation, and design of the patient information leaflet and focused on assessing patients' knowledge levels using questionnaires after providing the validated patient information leaflet. Methods: A prospective study was conducted among chronic kidney disease patients who were not on dialysis. The patient information leaflet was prepared based on experts' opinions and a thorough review of various resources. Experts validated the content of the patient information leaflet through the content validity index. After being validated, the Baker Able leaflet design scale was used to evaluate the layout and design. Knowledge assessment questions were validated using item-content validity index scores to assess patient knowledge before and after providing the patient information leaflet. Results: A total of 60 randomly selected chronic kidney disease patients were enrolled. The content validity index of the patient information leaflet was found to be 0.9. The Baker Able leaflet design score was found to be 25. Knowledge was assessed and it showed that score had increased from 42 ± 6.95 to 73.5 ± 6.70, respectively, with a P-value <0.000. Conclusion: This study concluded that the patient information leaflet was developed based on standard procedures. Significant improvement was seen in patients' knowledge after utilizing a validated patient information leaflet.

Development and Content Validity of a Disability Self-Management Questionnaire for Hispanic Older Adults

OBJECTIVE

There is no Spanish-language instrument for assessing the self-management strategies used by older adults with physical function disabilities to manage the difficulties that can occur in daily living activities. This study aimed to design and test the content validity of a Spanish version of the newly developed Self-Management of Function in Daily Living Activities Questionnaire (SF-DLAQ).

METHODS

A methodological study, guided by the Person-Environment-Occupation-Performance (PEOP) model, was conducted to develop the SF-DLAQ. Stage 1 focused on designing the questionnaire, doing so using qualitative data obtained from 24 older adults and obtained from 10 existing scales that measure the self-management of chronic conditions. Stage 2 focused on expert judgement, which consisted of validating the questionnaire with 8 experts in aging using an item-level content validity index (I-CVI), a scale-level CVI (S-CVI), and the kappa statistic.

RESULTS

All the scores that were attained in stage 2 were favorable, with those of the I-CVI for clarity ranging from 0.09 to 1.0 and those of the I-CVI for relevancy, the S-CVI, and the kappa all being 1.0.

CONCLUSION

The scale and item validity for the SF-DLAQ, Spanish version, has been demonstrated but should be confirmed with further testing.

Cross-Cultural Adaptation of Lung Cancer Screening Health Belief Scale in Chinese Americans: A Methodological Study

Background and Purpose: The purpose of this study is to report the process of adapting the existing Lung Cancer Screening Health Belief Scale to be used in Chinese Americans. Methods: Guided by Flaherty et al.'s cross-cultural equivalency model, the methodology used in the adaptation process consists of four steps, including preliminary modification after a comprehensive literature review, forward and backward translation, expert review, and cognitive interviews among participants. Results: The modified culturally fitted Lung Cancer Screening Health Belief Scale included 57 items and 6 subscales, which proved highly reliable and valid through the expert review and participants' review. Conclusions: This study provided an example for a novice cross-cultural researcher to adapt an instrument to be used in another population with a different language. Further research is needed to work out a standard guideline for cross-cultural instrument adaptation.

Adolescent sadfishing on social media: anxiety, depression, attention seeking, and lack of perceived social support as potential contributors

BACKGROUND

Sympathy-seeking negative online self-disclosure, or "sadfishing," has proliferated in social media. This study investigates sadfishing by developing and validating a brief self-report questionnaire of the construct and exploring potential psychological correlates.

METHODS

A total of 345 Iranian adolescent social media users (Mage = 16.29, SDage = 1.52) participated in the study. Participants completed the newly constructed Social Media Sadfishing Questionnaire, in addition to measures of anxiety, depression, attention seeking, perceived social support, and social media use integration.

RESULTS

Factor analyses revealed a unidimensional structure of the 5-item Social Media Sadfishing Questionnaire. The questionnaire yielded sound construct validity and internal consistency. Anxiety, depression, and attention seeking were positively associated with sadfishing, while perceived social support from family and friends was negatively associated with sadfishing. Negative online reactions to sadfishing were rare. Boys reported higher sadfishing tendencies than girls at age 12; however, sadfishing in boys declined at a higher rate than in girls with age.

CONCLUSIONS

The findings suggest that negative affect and attention seeking, combined with feelings of low social support, can be associated with adolescent sadfishing on social media. The quantitative results shed new light on the contribution of psychosocial factors to sadfishing.

Prevention and control of violence and aggression in football fans: Implications for sport psychologists, fans, and policymakers

This research was conducted to design an interpretive structural model of factors affecting the prevention and control of violence and aggression in football fans. The statistical population of this study was entirely composed of sport experts, executive managers, sociologists, and management professors in Iran. Thirteen individuals were accordingly selected as the research sample using non-probability purposeful sampling. The effective factors were identified through library study and reviewing the theoretical foundations and research background. Confirming the content validity of these factors by considering experts' opinions, 14 factors were finally identified. The interrelationships between the factors were determined using Interpretive Structural Modeling (ISM), and network analysis based on Decision Making and Trial Evaluation Laboratory (DEMATEL) was also employed to measure their importance, ranking them accordingly. The factors were categorized into four levels according to ISM. The highest level (first level) includes "match day service quality," "fair refereeing," "consolidation of social ties," and "cognitive reconstruction of fans." The second level contains "design, protection, and security of stadiums," "patterning and identification," and "use of calming techniques." "Awareness and informing" and "anger control training" belong to the third level, while the lowest level (fourth level) includes "media," "fan organizations," "laws, regulations, and security solutions," "moral education or persuasion," and "teaching communication skills to fans." Among them, the last level is fundamental, influencing the other factors. The results obtained in this work can be used as a basis for policymaking to reduce violence and aggression among football fans.

Self-assessment of residents in breaking bad news; skills and barriers

INTRODUCTION

Breaking bad news (BBN) is inevitable in medicine and is one of the most important and difficult professional tasks of physicians. The main aims of this study are to evaluate residents' practice of BBN and identify perceived barriers to its implementation.

METHODS

In this cross-sectional study in 2021, 240 residents from medical, surgical, and emergency medicine departments completed the demographic questionnaire, the Persian SPIKES questionnaire (P-SPIKES), and the researchers-made questionnaire of Barriers to Breaking Bad News (BBBN). In addition, they were asked about their previous experience, previous training, and their perceived level of competence in BBN.

RESULTS

46.5% and 36.84% of residents rated their perceived competence in BBN and managing the patient's emotions during BBN as good or very good, respectively. The most difficult aspects of BBN for residents were expressing upsetting information (78.1%) and not disappointing the patient while being honest (58.3%). The mean and standard deviation of the score of the P- SPIKES was 55.92 ± 6.84. The most common SPIKES item was not giving bad news by phone (98.9%). The SPIKES total score was only related to age (positive relationship). The most commonly reported barriers to BBN were concerns about controlling the patient's emotions (61%) and the aggressiveness of the patient or companions (52.6%). A significant proportion of participants identified lack of training (28%) and insufficient skills (21.9%) as significant barriers to BBN.

CONCLUSIONS

The skill of residents in BBN is insufficient in some aspects and points to the need for BBN training courses during residency. BBN is difficult for residents in some aspects and residents may perceive barriers. To overcome the existing barriers and increase residents' confidence in BBN, strategies such as incorporating BBN training into residency educational curricula and communication skills are recommended.

Content Validity of the Left Ventricular Assist Device Bathing Assessment

Many institutions recommend modified bathing techniques for individuals with left ventricular assist devices (LVADs) due to infection risk. Although these techniques may be challenging for patients, there currently is no assessment to evaluate these skills and whether intervention programs have been successful. This article describes the development and content validation of the LVAD Bathing Assessment. The content validity index (CVI) process was used to determine the relevance of assessment items. Modified Kappa indices were calculated to account for the possibility of chance agreement among raters. Eight content validity experts rated each assessment item and provided feedback. The overall assessment and 44 of 47 individual items had excellent content validity (scale-level CVI [S-CVI] = 0.97; item-level CVI [I-CVI] > 0.78). Minor revisions were made based on feedback. Creation of an LVAD bathing assessment may improve care by identifying safety risks that may cause infection. Further studies for construct validation and reliability testing are needed.

Psychometric Properties of the Spiritual Coping Strategies Scale-Chinese Version (SCSS-C) for Adults in Taiwan

This study examined the psychometric properties of the Spiritual Coping Strategies Scale-Chinese version (SCSS-C) in Taiwanese adults. A convenience sample of 232 participants in Taiwan completed an online survey, and 45 of the 232 participants completed the SCSS-C again over a 2 week interval. The content validity index of the SCSS-C was 0.97. Parallel analysis and exploratory factor analysis results revealed two factors (religious coping and non-religious coping). The internal consistency of the SCSS-C was satisfactory (α = 0.88 to 0.92). Test-retest reliability was satisfactory (r = 0.68 to 0.89). The psychometric properties of the SCSS-C were found to be acceptable for use in Taiwanese adults.

Co-designing psychosis simulated patient scenarios with mental health stakeholders for pharmacy curricula

BACKGROUND

Pharmacists need knowledge and confidence to support people living with mental illness. Evidence-based educational materials for pharmacy students to provide psychosis care is limited.

AIM

To co-design, content validate and pilot-test, with mental health stakeholders, simulated patient scenarios to educate and assess students in providing psychosis care.

METHOD

Mental health consumers were invited to co-design three simulated patient scenarios (first-episode psychosis, carer of someone living with schizophrenia, non-adherence to antipsychotics), guided by published and psychometrically-tested materials. A panel of mental health stakeholders participated in two rounds of content validation (RAND/UCLA appropriateness model). Round 1 involved individual survey completion to calculate item content validity index (I-CVI) for relevance/clarity, content validity ratio for essentiality and overall scale content validity index (S-CVI/Ave and S-CVI/UA) scores for each scenario. Scores analyses and feedback comments informed revisions. Round 2 involved a panel meeting to discuss revisions and finalise content. The scenarios were then pilot-tested with pharmacy students.

RESULTS

Two consumers participated in co-design, nine stakeholders in content validation. All items showed excellent content validity for relevance/clarity. Eleven items were revised for essentiality, discussed, then re-rated at the panel meeting for consensus. The scenarios were pilot-tested with pharmacy students (n = 15) and reported to be realistic and relevant to future practice, contributing to students' confidence in supporting people experiencing mental health symptoms or crises.

CONCLUSION

Partnering with mental health stakeholders has enabled co-design of authentic, content valid educational materials for pharmacy students to provide psychosis care, in preparation for future provision of mental health support.

Development and validation of assessment instrument for the perception and attitude toward tuberculosis among the general population in Indonesia: a Rasch analysis of psychometric properties

Introduction

Tuberculosis (TB)-related knowledge is an important evaluation metric for health education interventions. Factor analysis is limited when used on ordinal scales and does not provide in-depth item function examinations, whereas Rasch analysis addresses these limitations and offers potential advantages such as generalizability, testing of unidimensionality, producing an ordered set of items, and identifying poorly functioning items. Therefore, this research aims to develop a reliable and valid measure of perception and attitude toward TB (PATT) for public application use Rasch Analysis.

Methods

A questionnaire-based survey was conducted on the Indonesian general population using the Google Form platform. Rasch analysis was then employed to examine the psychometric properties and develop the final items of PATT.

Results

Experts from across the TB community participated in the PATT development, producing an initial scale of 16 items. Up to 1,616 participants completed the PATT questionnaire, where 74.8% were female, and 5% had a TB history. The final unidimensional 16-item scale has an item reliability of 1.00 for the two components (perception and attitude), a person reliability index of 0.87 and 0.60, as well as a Cronbach's test reliability of 0.88 and 0.88 for perception and attitude, respectively.

Conclusion

The PATT is a unidimensional scale with good construct validity and internal consistency. It has the potential to be useful for the assessment of TB perception and attitude in research and clinical practice.

Development and validation of parental knowledge, attitude and practice in eye problem among children questionnaire (PEPC-KAPQ)

BACKGROUND

Most eye problems among children can be detected and treated at an early age to reduce the prevalence of visual impairment. Understanding the knowledge, attitude, and practice (KAP) among parents about common children's eye problems is fundamental to encourage parents to seek early eye care services for their children. This study aims to develop a Parental Knowledge, Attitude, and Practice in Eye Problem among Children Questionnaire (PEPC-KAPQ) and evaluate its psychometric properties.

METHODS

This study involved developing a questionnaire and was conducted in Kuala Lumpur, Malaysia from July 2021 until June 2022. The questionnaire was developed based on a literature review and expert consultation. The first phase includes a systematic literature review to generate the items for the questionnaire. A group of five panels was then invited to perform content validity for the questionnaire. Face validity was conducted among ten parents to get feedback for the questionnaire. Construct validity and reliability of the questionnaire were measured by which the questionnaire was administered to a total of 134 parents and 64 parents for reliability test.

RESULT

The final PEPC-KAPQ consists of four main sections: demographic, knowledge, attitude, and practice with 52 items. The content validity index was 0.85 for all domains of KAP. Modified kappa showed excellent value for most items for all domains. The Kaiser-Meyer-Olkin sampling adequacy showed acceptable scores of 0.84, and Bartlett's Test of Sphericity was significant (x2 = 3172.09, p<0.0001). Kuder-Richardson-2 of the domain knowledge was 0.95. Cronbach's α coefficient of domain attitude and practice were 0.92 and 0.88, respectively and the intraclass correlation of domain attitude and practice were 0.93 and 0.94 respectively. Bland and Altman's plots show that majority of the data fell within the limits of agreement.

CONCLUSION

The findings of this validation and reliability study show that the developed questionnaire has a satisfactory psychometric property for measuring the KAP of parents regarding eye problems among children.

The APISS Questionnaire: A New Tool to Assess the Epidemiology of Systemic Allergic Reactions to Bee Venom in Beekeepers

Aim

To develop and validate a comprehensive questionnaire to be used as an instrument in cross-sectional studies among beekeepers.

Methods

A comprehensive questionnaire in Slovenian was validated by an expert panel (n=13) for content relevance and a rater panel (n=14) for clarity and comprehensibility. The content validity indices (an item-level content validity index and scale-level content validity index based on the average and universal agreement method) and item-level face validity index were calculated in accordance with the recommended number of both the review panels with their implications on the acceptable cut-off scores. Piloting was performed in a sample (n=50) of the target population (N=1.080) using telephone interviews.

Results

The item-level content validity index and scale-level content validity index based on the average method exhibited excellent content validity (0.97), while the scale-level content validity index based on the universal agreement method reached a value of 0.72. The item-level face validity index of 1.00 indicated that all items were clear and comprehensive.

Conclusions

The new instrument may be considered valid and feasible for use in nationwide population-based studies among Slovenian beekeepers and eventually in other populations.

Creation of a Short-Form and Brief Short-Form Version of the Coping With Children's Negative Emotions Scale

The Coping with Children's Negative Emotions Scale (CCNES) is a widely used measure of parent emotion socialization; however, it is a lengthy measure and it is unclear whether all items are appropriately aligned with, and fully capture, the underlying constructs. We aimed to examine content validity of the CCNES, evaluate the theoretical alignment between the CCNES and Gottman, Katz and Hooven's meta-emotion theory, and develop two short-forms. Participants were parents of children aged 4 to 10 years (N = 937) from the longitudinal study the Child and Parent Emotion Study (https://bmjopen.bmj.com/content/10/10/e038124). Content experts qualitatively evaluated parent-report items of the CCNES and additional items that measured empathy. Nineteen of the 84 items were found to not align with the meta-emotion theory. The latent structures of the CCNES and empathy subscales were quantitatively evaluated via confirmatory factor analysis. Items with poor psychometric properties were subsequently removed. An 18-item short-form (three emotion coaching subscales, three emotion dismissing subscales) and 6-item brief short-form (one emotion coaching subscale, one emotion dismissing subscale) with strong psychometric properties were created using a calibration sample (n = 468, that is, 50% of N = 937) and cross-validated with a validation sample. The short-form CCNES measures provide viable, theoretically consistent alternatives to the original CCNES measure.

Early Sport Specialization and Long-term Throwing Arm Health in College Baseball Players

BACKGROUND

Early sport specialization is associated with increased risk of overuse injuries in several sports, including baseball. However, limited evidence exists evaluating how early sport specialization affects patient-reported outcome measures as they age. The purpose of this study was to determine differences in Kerlan-Jobe Orthopedic Clinic (KJOC) Shoulder and Elbow Scores among collegiate baseball players based on the grade when a participant first reported high specialization behaviors.

HYPOTHESIS

Baseball players who were highly specialized at a younger age will have worse throwing arm health while participating in college.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 752 college baseball players was contacted through their institution's athletic trainer. We measured baseball specialization and KJOC scores using the validated Baseball and Sport Experience survey. Data were summarized using means and SDs, medians and interquartile ranges (IQRs), and frequencies and percentages. A Kruskal-Wallis test was used to determine differences in mean KJOC scale scores based on the earliest time the participant reported high-level specialization.

RESULTS

A total of 294 baseball players completed the survey (response rate: 39.1%). Of the 294 participants, 280 completed the KJOC scale questions to generate a total KJOC score (median: 90.5; IQR: 76.6-97.2). No significant differences in KJOC total scores (P = 0.78) existed based on the grade period in which the athlete was first highly specialized.

CONCLUSION

Early baseball specialization as a youth baseball player may not impact throwing arm health in college baseball athletes.

CLINICAL RELEVANCE

Early specialization has been linked to increased risk for overuse injuries in certain sports, but may not lead to poorer throwing arm health in college baseball players. Sports medicine clinicians and researchers may use this information to educate various stakeholders about the benefits and risks associated with early sport specialization.

Development and Validation of Questionnaires to Assess Workplace Violence Risk Factors (QAWRF): A Tripartite Perspective of Worksite-Specific Determinants in Healthcare Settings

Introduction

Workplace violence (WPV) incidences are prevalent in healthcare, and existing WPV interventions have only moderate evidence for effectiveness. This study aimed to develop and validate an instrument to assess worksite-specific WPV risk factors in healthcare settings based on a tripartite perspective of key stakeholders to facilitate improved interventions.

Methods

Three questionnaires were developed to get the responses from healthcare administrators, workers, and clients, representing the three components of Questionnaires to Assess Workplace Violence Risk Factors (QAWRF). The domains of the questionnaires were developed based on The Chappell and Di Martino's Interactive Model of Workplace Violence, and the items were generated from 28 studies identified from a systematic review of the literature. Six experts, 36 raters, and 90 respondents were recruited to assess the content validity, face validity, and usability and reliability of the QAWRF respectively. Item and Scale Level Content Validity Index, Item and Scale Level Face Validity Index, and Cronbach's alpha values were determined for QAWRF-administrator, QAWRF-worker, and QAWRF-client.

Results

The psychometric indices for QAWRF are satisfactory.

Conclusion

QAWRF holds good content validity, face validity, and reliability, and findings from QAWRF can contribute towards worksite-specific interventions that are expected to be resource efficient and more effective than general WPV interventions.