An Improved Stress-Scale Specifically Designed to Measure Stress of Women with Newly Diagnosed Breast Cancer

Psychometric evaluation of the Chinese version of the stressors in breast cancer scale: a translation and validation study

OBJECTIVE

To translate the Stressors in Breast Cancer Scale (SBCS) from English to Chinese and assess its psychometric properties.

METHODS

The Brislin's translation model was applied to perform forward translation, back translation, cross-cultural adaptation, Whereas the Chinese version of the SBCS was formed by conducting pre-testing. A cohort of 878 breast cancer patients participated in this methodological study. Content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity were used to establish validity. Internal consistency reliability, split-half reliability, and test-retest reliability were used to establish reliability.

RESULTS

The final scale contained five dimensions and 24 items, including interpersonal relationship and healthcare strains, worries and concerns about the future, physical appearance and sex strains, daily difficulties and health. The average content validity index of the scale was 0.975. The goodness-of-fit index (χ2/DF = 2.416, RMSEA = 0.057, GFI = 0.896, CFI = 0.947, IFI = 0.947, and TLI = 0.939) indicated that the model was well-fitted. The composite reliability (CR) of the dimensions ranged from 0.825 to 0.934, the average variance extracted (AVE) ranged from 0.539 to 0.712, and the correlation coefficients of each dimension with the other dimensions were less than the square root of the AVE for that dimension. The Criterion-related validity was 0.511. The Cronbach's alpha was 0.938, and the dimensions ranged from 0.779 to 0.900. Split-half reliability was 0.853, with dimensions ranging from 0.761 to 0.892. Test-retest reliability was 0.855.

CONCLUSIONS

The Chinese version of the SBCS has good reliability and validity, which can be applied to the assessment of stressors in breast cancer patients in China.

Adopting e-government to monitor public infrastructure projects execution in Nigeria: The public perspective

Public infrastructure projects (PIPs) are critical to the socioeconomic development of any country and similar to most public activities, their governance requires effective public participation to be successful. Information and communication technology adoption in government-public engagements (i.e., e-government) has improved public participation in governance in developed countries. This study utilizes the unified theory of acceptance and use of technology to investigate determining factors for the Nigerian public to adopt e-government tools to promote public participation in monitoring PIPs execution. It adopts questionnaire survey and structural equation modelling techniques to show that performance expectancy, facilitating conditions, social influence, and effort expectancy significantly and positively affect behavioral intention to adopt e-government tools to monitor PIPs execution in Nigeria. This study provides scholars with an exploratory baseline for extension of e-government adoption to public infrastructure project management. This study also provides recommendations to policy makers, government technocrats, and project engineers on the need for policy changes, creation of interactive and up-to-date project websites for PIPs in Nigeria.

Development and psychometric properties of the Stressors in Breast Cancer Scale

Background

A diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient’s daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer.

Aims

The aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS).

Method

A panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed.

Results

Validity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald’s omega and Cronbach’s alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life.

Discussion

The results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.

Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients

Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.

Determinants of Customer Intentions to Use Electric Vehicle in Indonesia: An Integrated Model Analysis

Electric vehicles can be a solution to certain social problems in Indonesia, such as pollution and an increase in consumption of energy from fossil fuels, which cannot be met by domestic production. The discussion of the TPB theoretical model, UTAUT2, and risk perception, using the structural equation modeling (SEM) method, in this study aims to provide an overview of the factors that drive interest in adopting electric vehicles in Indonesia. Data were collected from 526 respondents in various cities located in Indonesia. The results showed that the model can estimate the study variables adequately. The constructs of TPB such as attitude toward use (ATU), subjective norm (SBN), and perceived behavior control (PBC) positively affect interest in using electric vehicles. Meanwhile, ATU is influenced by performance and effort expectancies, hedonic motivation, price value, as well as functional, financial, and social risks. Another factor, known as PBC, is influenced by certain facilitating conditions. The ATU factor is the most influential on the use of electric vehicles, therefore factors such as performance expectancy, effort expectancy, hedonic motivation, price value, functional risk, financial risk, and social risk need to be properly analyzed.