Development of an instrument based on the theory of planned behavior variables to measure factors influencing Iranian adults' intention to quit waterpipe tobacco smoking

Development and Preliminary Validation of the Chinese Version of the Totally Implantable Venous Access Port Self-Management Behavior Scale (CPTSMBS) for Patients with Cancer

Objective

This study aimed to develop the Chinese version of the totally implantable venous access port (TIVAP) self-management behavior scale for patients with cancer to provide a reliable tool for medical staff to judge patients with TIVAP self-management behavior.

Methods

This study employed a mixed-method exploratory design. The initial scale was developed through a literature review, expert meetings, and two-round Delphi expert consultation. The reliability indicators included retest reliability and Cronbach's alpha coefficients. The validity indicators included content, construct, convergent, discriminant, and criterion validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed for the validity analysis; 22 venous therapy experts participated in the Delphi expert consultation. A total of 500 patients were recruited from two third-class A hospitals in Guangdong Province, China, between July 2020 and January 2021 to test reliability and validity. A convenience sampling method was adopted.

Results

The final scale comprised seven dimensions and 29 items. The content validity index (S-CVI) was 0.990. Cronbach's alpha coefficient and retest reliability of the scale were 0.931 and 0.900, respectively. The EFA results indicated a seven-factor structure, accounting for 65.68% of the total data variance. The results of the CFA showed that the CMIN/DF value was 2.348; the root mean square error of approximation value was 0.06; and the values of comparative fit index, incremental fit index, and Tucker-Lewis index were all >0.90. The factor loadings for all the items were >0.50, the composite reliability value was >0.70, and the average variance extracted (AVE) value was >0.50. Moreover, all absolute values of the correlation coefficients were less than the square root of the AVE for the seven dimensions. The total scores between the health promoting lifestyle profile-II revise (HPLP-IIR) and CPTSMBS were positively correlated (r = 0.465, p < 0.01).

Conclusion

The scale demonstrated good reliability and validity and can be applied in clinical practice to evaluate self-management behavior among patients using a TIVAP.

Psychometric evaluation of a new instrument to hookah tobacco smoking-related factors in the Iranian female university students based on the Extended Parallel Process Model

BACKGROUND

The higher prevalence of hookah tobacco smoking (HTS) has become worrisome in women. Thus, it is essential to identify and measure the perceptions associated with this unhealthy behavior as well as the type of response to risk messages to design the effective programs. This study aimed to psychometric evaluation of a new instrument, named the Extended Parallel Process Model-Hookah Tobacco Smoking Questionnaire (EPPM-HTSQ), for female university students.

MATERIAL AND METHODS

This methodological study was conducted in 2019-2020 in central and western Iran. The first version of the instrument was developed with 97 items. Face, Content, and construct validity methods were used to assess the EPPM-HTSQ validity. The data viability for factorability was guided through Kaiser-Meyer-Olkin (KMO) measure of sample adequacy (Values >0.7) and Bartlett's test of Sphericity (P < 0.05). The Exploratory Factor Analysis (EFA) method with varimax rotation and SPSS software was performed to identify the main factors of the questionnaire and interpretable factors. The internal consistency and external reliability were determined. The test-retest was used for evaluating the stability of tools.

RESULTS

During the assessment of the face and content validity 71 items remained in the questionnaire. EFA led to the extraction of nine dimensions: "Focusing on superior rewards," "Response Efficacy," "Perceived physical threat," "Perceived social threat," "Self-efficacy," "Fear control," "Attitude," "Fear," and "Intention" Kaiser-Meyer-Olkin (KMO) test (0.957) and Bartlett's test (P < 0.001). Cronbach's alpha (0.871-0.951) and ICC (0.985-0.998) were approved for scale dimensions.

CONCLUSION

Important findings of the present study were the development and validation of the EPPM-HTSQ for measuring EPPM variables in relation to HTS; introducing a new variable "focusing on superior rewards"; as well as, the new classification of the concept of "perceived threat." The final version of the EPPM-HTSQ is a valid and reliable tool, but it is suggested to be re-evaluated in other studies with different populations and sample sizes.

The development of career planning scale for junior high school students based on cognitive information processing theory

Based on the career theory of Cognitive Information Processing (CIP), we selected scale items from literature reviews and expert guidance. The scale consisted of 28 items with 4 factors (interests, abilities, values, personality). To test the scale's factor structure, we used confirmatory factor analysis (CFA), and the model was modified according to CFA results. The second-order confirmatory factor analysis was applied to the model of the scale to prove the rationality of the total score. The internal consistency were evaluated using Cronbach's alpha coefficients. In addition, the composite reliability (CR) and average variance extraction (AVE) of the scale were also calculated to test the convergent validity. After related analyses, the scale was proved to have good psychometric properties, which can be used to measure junior high school students' career planning level in information technology course from the aspects of interest, ability, values, and personality. The effect of the first-order confirmatory factor analysis model constructed in this study is not ideal. Therefore, on this basis, a second-order confirmatory factor analysis model is constructed in combination with existing literatures, and the rationality of the model is verified through data, which highlights the novelty of this study.

The Intention of Waterpipe Tobacco Smoking by Women in the COVID-19 Pandemic and its Contributing Factors: a Nonparametric Path Analysis

Background

People with waterpipe tobacco smoking (WTS) seem to be more at risk for the serious complications of coronavirus disease 2019 (COVID-19). This study aimed at assessing the behavioral intention (BI) of WTS by women in the COVID-19 pandemic and its contributing factors.

Methods

This cross-sectional descriptive-correlational study was conducted in 2020 (ie, during the COVID-19 pandemic). Participants were 300 women randomly selected through multistage sampling from comprehensive healthcare centers in Khorramabad, Iran. Data collection instrument was a 42-item questionnaire with 4 main subscales, namely knowledge, attitude, differential association, and BI. Data were collected through both online and phone-based methods and were analyzed using non-parametirc path analysis.

Results

The prevalence of WTS among women was 13% (95% CI, 11.06-14.94) and the mean scores of attitude, differential association, and behavioral intention among participants with WTS were significantly higher than participants without WTS (P < 0.001). Moreover, 46.12% (95% CI, 38.12-54.08) of participants with WTS reported intention to quit WTS due to the COVID-19 pandemic and 43.6% (95% CI, 35.66-51.54) of women with WTS and 16.5% (95% CI, 14.20-18.80) of women without WTS believed in the protective effects of WTS against COVID-19. The path analysis model showed that the BI of WTS had a significant inverse relationship with knowledge and a significant direct relationship with attitude and differential association.

Conclusion

This study suggests the need for quality educational and counseling interventions for the general public to correct popular misconceptions about the protective effects of WTS against COVID-19.

More Information, Greater Appreciation: The Correlation between Background Information and Aesthetic Judgment of Tourist Crafts

More information is often correlated with greater appreciation. Drawing on the model of aesthetic appreciation and aesthetic judgment in art psychology, this study aims to investigate changes in tourists' aesthetic judgments of tourist crafts when provided with different background information. Blue calico, an art form created through white pulp dyeing and printing, is an intangible cultural heritage of China. The photographs used in this study illustrate typical examples of blue calicos that are commonly sold in tourist gift shops in Wuzhen, China. Data from a sample of 133 participants (49 women and 84 men) was analyzed using Two-Way Repeated Measures ANOVA. We examined to what extent respondents varied their assessments of the calicos based on author manipulation of background factors, such as commentaries by the artist or details about the production process. We found that tourists' impressions of the aesthetics of blue calicos were predicted by background factors, especially those of tourists who were less interested in high arts. Specifically, blue calicos reported to tourists with names that conveyed an auspicious meaning predicted tourists' assessments of the calicos as more aesthetically pleasing. Explanations of the production process also predicted an increased appreciation of calico aesthetics. Conversely, artists' commentaries were not significantly correlated with an increased aesthetic merit of calicos. Understanding what may affect tourists' assessment of art could help those in the tourism industry market souvenirs to drive sales and enhance tourists' understanding and appreciation of intangible cultural heritage.

The role and importance of perceived risk in medical tourism. Applying the theory of planned behaviour

The main aim of the study was to investigate the role and importance of perceived risk in medical tourism (MT). The research demonstrates that the country of origin and an assessment of the respondents’ own health condition significantly moderates the impact of their attitudes on behavioral intention. The research shows a strong correlation between the risk perceived by the respondents and their attitudes towards MT services. This relationship is significantly moderated by risk awareness, aversion to risk and gender. Additionally, an important factor in the model is the level of satisfaction with medical services in their own country. The survey using a fully structured questionnaire was conducted among young consumers from Jordan, Poland and Turkey. To verify the hypotheses, a multiple regression model with interactions was used.

An Application of the Theory of Planned Behavior to Predict the Intention and Practice of Nursing Staff Toward Physical Restraint Use in Long-Term Care Facilities: Structural Equation Modeling

PURPOSE

Understanding the factors that affect nursing staffs' intention and practice of physical restraint (PR) on older adults help develop restraint-reduction programs. This study aimed to identify the relationship between the Theory of Planned Behavior (TPB) constructs and nursing staffs' practice to use PR in long-term care (LTC) facilities.

PATIENTS AND METHODS

A cross-sectional survey was conducted via convenience sampling among 316 nursing staff in six Chinese LTC facilities. PR-TPB questionnaire and the practice subscale of the Chinese version of the Staff Knowledge, Attitudes and Practices Questionnaire regarding PR were used to collect the data. Structural equation modeling (SEM) was used to examine the relationship between variables.

RESULTS

The SEM fit well with the data (χ2/df =1.639, RMSEA = 0.045, CFI= 0.955, GFI=0.945). Attitude (β=0.536, P<0.001) and perceived behavioral control (PBC) (β=0.139, P<0.05) predicted intention (R2 =0.359). PBC was a significant predictor of practice, with R2 accounting for 0.151.

CONCLUSION

TPB provided useful insight into better understanding nursing staffs' PR practices, although it did not support all the TPB principles significantly. Prospective studies may be conducted to design and implement multi-component interventions based on TPB and explore the effectiveness of PR reduction in LTC facilities in-depth.