Validating an Instrument for Measuring Newly Graduated Nurses' Adaptation

Mediating effect of cognitive appraisal and coping on anticipatory grief in family caregivers of patients with cancer: a Bayesian structural equation model study

BACKGROUND

Anticipatory grief is common among family caregivers of cancer patients and may be related to caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping strategies. The purpose of this study was to examine the mediating role of cognitive appraisal and coping strategies in the relationship between caregiver burden, family resilience, psychological capital, and anticipatory grief among caregivers of cancer patients.

METHODS

This study surveyed from January to September 2023 among 265 caregivers of lung and breast cancer patients in two public hospitals. They completed measures of caregiver burden, family resilience, psychological capital, cognitive appraisal, coping, and anticipatory grief. AMOS software was used to model the data with Bayesian structural equation modeling.

RESULTS

Bayesian structural equation modeling results showed that caregiver burden had a direct effect on anticipatory grief. The chain mediating effects for cognitive appraisal tendency and coping tendency between caregiver burden, family resilience, psychological capital, and anticipatory grief, respectively. Coping tendency acted as a mediator between psychological capital and anticipatory grief.

CONCLUSIONS

The relationships between caregiver burden, family resilience, and psychological capital with anticipatory grief are embedded in the mediating effects of cognitive appraisal and coping. Early identification and intervention for caregiver burden, family resilience, psychological capital, cognitive appraisal, and coping methods may prevent anticipatory grief in caregivers of cancer patients.

Validation of a quantitative instrument measuring critical success factors and acceptance of Casemix system implementation in the total hospital information system in Malaysia

OBJECTIVES

This study aims to address the significant knowledge gap in the literature on the implementation of Casemix system in total hospital information systems (THIS). The research focuses on validating a quantitative instrument to assess medical doctors' acceptance of the Casemix system in Ministry of Health (MOH) Malaysia facilities using THIS.

DESIGNS

A sequential explanatory mixed-methods study was conducted, starting with a cross-sectional quantitative phase using a self-administered online questionnaire that adapted previous instruments to the current setting based on Human, Organisation, Technology-Fit and Technology Acceptance Model frameworks, followed by a qualitative phase using in-depth interviews. However, this article explicitly emphasises the quantitative phase.

SETTING

The study was conducted in five MOH hospitals with THIS technology from five zones.

PARTICIPANTS

Prior to the quantitative field study, rigorous procedures including content, criterion and face validation, translation, pilot testing and exploratory factor analysis (EFA) were undertaken, resulting in a refined questionnaire consisting of 41 items. Confirmatory factor analysis (CFA) was then performed on data collected from 343 respondents selected via stratified random sampling to validate the measurement model.

RESULTS

The study found satisfactory Kaiser-Meyer-Olkin model levels, significant Bartlett's test of sphericity, satisfactory factor loadings (>0.6) and high internal reliability for each item. One item was eliminated during EFA, and organisational characteristics construct was refined into two components. The study confirms unidimensionality, construct validity, convergent validity, discriminant validity and composite reliability through CFA. After the instrument's validity, reliability and normality have been established, the questionnaire is validated and deemed operational.

CONCLUSION

By elucidating critical success factor and acceptance of Casemix, this research informs strategies for enhancing its implementation within the THIS environment. Moving forward, the validated instrument will serve as a valuable tool in future research endeavours aimed at evaluating the adoption of the Casemix system within THIS, addressing a notable gap in current literature.

Optimizing young tennis players' development: Exploring the impact of emerging technologies on training effectiveness and technical skills acquisition

The research analyzed the effect of weekly training plans, physical training frequency, AI-powered coaching systems, virtual reality (VR) training environments, wearable sensors on developing technical tennis skills, with and personalized learning as a mediator. It adopted a quantitative survey method, using primary data from 374 young tennis players. The model fitness was evaluated using confirmatory factor analysis (CFA), while the hypotheses were evaluated using structural equation modeling (SEM). The model fitness was confirmed through CFA, demonstrating high fit indices: CFI = 0.924, TLI = 0.913, IFI = 0.924, RMSEA = 0.057, and SRMR = 0.041, indicating a robust model fit. Hypotheses testing revealed that physical training frequency (β = 0.198, p = 0.000), AI-powered coaching systems (β = 0.349, p = 0.000), virtual reality training environments (β = 0.476, p = 0.000), and wearable sensors (β = 0.171, p = 0.000) significantly influenced technical skills acquisition. In contrast, the weekly training plan (β = 0.024, p = 0.834) and personalized learning (β = -0.045, p = 0.81) did not have a significant effect. Mediation analysis revealed that personalized learning was not a significant mediator between training methods/technologies and acquiring technical abilities. The results revealed that physical training frequency, AI-powered coaching systems, virtual reality training environments, and wearable sensors significantly influenced technical skills acquisition. However, personalized learning did not have a significant mediation effect. The study recommended that young tennis players' organizations and stakeholders consider investing in emerging technologies and training methods. Effective training should be given to coaches on effectively integrating emerging technologies into coaching regimens and practices.

[Internal validity and reliability of an instrument for evaluating quality of nursing care services for patients, nurses, and family members]

AIM

To analyze the internal validity and reliability of the instrument for evaluating the quality of services adapted to three interest groups: patients, nurses, family members, and primary caregivers.

MATERIAL AND METHOD

Our research was conducted meticulously, employing a mixed methodology with two phases: qualitative, using the focus group for internal validation of the instrument, and quantitative. Subsequently, the survey was passed to the interest group of 430 patients, 525 relatives, and 298 nurses. Chronbac's alpha reliability analysis, the multiple linear regression model as a point estimator of the parameters, and exploratory factor analysis with a maximum likelihood factor using Kaiser-Meyer-Olkin to analyze the constructor and its indicators were performed to validate the adaptation. Finally, confirmatory factor analysis determines their respective measurement models' unidimensionality, validity, and reliability.

RESULTS

The result shows that the factor loading of each subconstruct is more significant than 0.5 in the three models, which indicates that the aptitude indices of the model were met. In addition, the model meets the discriminant validity criteria. The behavior of the SERVPERF questionnaire was analyzed in terms of consistency, Cronbach's alpha=0.94.

CONCLUSION

The scale items' discrimination concerning the questions on global satisfaction is confirmed. This shows that the instrument is valid, reliable, and useful.

Development and validation of Digi-MEE Instrument measuring online learning environments in medical education

Objectives

To develop and validate Digital Medical Education Environment (Digi-MEE) Instrument for measuring online learning environment in medical education.

Methods

This series of studies involved 696 participants from May 2022 to December 2022. Following scoping review, invited modified e-Delphi experts developed consensus on the components and related items for measuring online learning environments. A panel of content experts and a group of medical students carried out content and response-process validation to determine Content Validity Index (CVI) and Face Validity Index (FVI) respectively. This was followed by exploratory and confirmatory factor analysis and reliability analysis to determine Digi-MEE's factorial structure and internal consistency using SPSS version 26.0 and AMOS 26.0.

Results

Delphi experts agreed upon nine components with 73 items of initial Digi-MEE version. CVI of Digi-MEE 2.0 was more than 0.90. with FVI of Digi-MEE 3.0 of 0.87. Exploratory factor analysis yielded 46 items with 57.18% variance. Confirmatory factor analysis led to the final Digi-MEE version containing 28 items within nine components with acceptable levels of goodness of fit indices. Overall Cronbach alpha of the final Digi-MEE was more than 0.90, and for the nine components ranged between 0.62 and 0.76.

Conclusion

Digi-MEE is a promising valid and reliable instrument to evaluate online education environment in medical education. Content, response-process, factorial structure, and internal consistency evidence support the validity of Digi-MEE. Medical schools can use Digi-MEE as an evaluation tool for the continuous quality improvement of online learning environments.

Psychometric evaluation of the Malay version of the Individual Community-Related Empowerment scale among older adults in Malaysia

Background

Malaysia is projected to become an aged country by 2030, with the older age group comprising 10 percent of the total population. To address this demographic shift, comprehensive plans and initiatives are being implemented at various levels, ranging from the government to local communities. A crucial aspect of these efforts is community empowerment, which requires a reliable and validated tool for measurement.

Objective

This study aimed to validate the Individual Community Related Empowerment (ICRE) scale in alignment with the national language of Malaysia.

Methods

This cross-sectional study was conducted from May to December 2019. Back-to-back translation from the English to Malay version of the ICRE scale was done. A total of 328 older persons aged 60 years old and above who attended clinics and understood Malay had been randomly selected. Exploratory factor analysis (EFA), particularly Principal Component Analysis (PCA) with Varimax rotation and Kaiser Normalization, was performed in this study using IBM SPSS version 27 Amos graphic.

Results

The findings revealed that the Malay version of the Individual Community Related Empowerment (ICRE-m) scale consists of five components: self-efficacy, intention, participation, motivation, and critical awareness, which collectively accounted for 92.3% of total variance. All five components demonstrated Cronbach's alpha values greater than 0.7, indicating the reliability of the selected items for field studies.

Conclusion

The ICRE-m scale is acceptable for field studies and valid for measuring individual-related community empowerment. Nurses and other healthcare professionals can employ this scale specifically within the Malay-speaking population, particularly in the Asian region. Future studies on community empowerment among older individuals can utilize this tool to assess community readiness for participating in community health interventions.

Success factors in adaptation of newly graduated nurses: a scoping review

BACKGROUND

Difficulties in adapting to the workplace can affect newly graduated nurses' transition. Such nurses must adapt quickly, as it can affect their future career prospects. Therefore, this review aimed to identify the success factors that promote newly graduated nurses' effective transition and adaptation.

METHODS

The Joanna Briggs Institute scoping reviews methodology was used. Data were extracted from MEDLINE, Scopus, EBSCOhost, and Web of Science publications published between 2011 and 2020. A total of 23 articles were included in this review, which comprised qualitative, quantitative, and mixed methods primary research studies focusing on the contributing factors that aided newly graduated nurses' adaptation to the work environment during their transition period. Key emerging themes were identified with thematic analysis.

RESULTS

Three main themes were identified: (1) organisational contribution (social development, organisational culture, work characteristics, work readiness, work commitment, professional role), (2) personality traits (self-embodiment, personality masking, being proactive and confident), and (3) academic institutions (pre-entry knowledge and role of nursing faculty). Newly graduated nurses' adaptation should begin during nursing education, be supported by the workplace organisation, and driven by the nurse's personality. We determined that that the role of nursing education in aiding the provision of the required knowledge and actual clinical experiences to students profoundly affected developing nurses' self-confidence levels in delivering nursing care effectively. Additionally, a warm environment supported nurses emotionally and physically.

CONCLUSIONS

While organisations and educational institutions have undertaken numerous efforts to ensure that newly graduated nurses are adequately supported, the nurse's personality and values are also equally important to ease adaptation during the transition process. Academic and workplace programs designed for newly graduated nurses should apply and emphasise this knowledge to develop and strengthen their personalities and values, especially to increase confidence and promote proactive values that facilitate newly graduated nurses' rapid and effective adaptation to their new employment.