SOLOMON: a method for splitting a sample into equivalent subsamples in factor analysis

Nurses' attitudes towards telehealth: The development and validation of the nurses' attitudes towards the use of telehealth scale

AIM

To develop the nurses' attitudes towards use of a telehealth scale (NATUTS) and evaluate its psychometric properties.

DESIGN

This methodological study involved two stages: the development of the NATUTS and the testing of the psychometric properties of NATUTS. We followed STROBE guidelines when reporting the study (File S1).

METHODS

Items for NATUTS were created using evidence from the literature and presented to eight experts. The scale was tested in a methodological study conducted through a face-to-face survey with nurses working in outpatient and inpatient units of a tertiary hospital in Türkiye. Psychometric properties of the scale, such as structural validity, content validity and internal consistency reliability, were tested. The sample, consisting of 630 nurses, was divided into two separate random groups. Exploratory factor analysis was conducted with the data of the first 330 people, and confirmatory factor analysis was conducted with the data of the remaining 300 people.

RESULTS

A 19-item, three-factor structure (Satisfaction, Rejection, Development) was obtained in the newly developed scale. In NATUTS, Factor 1 (α = .93), Factor 2 (α = .86) and Factor 3 (α = .87) measured 64.4% of the total variance. The entire 19-item acceptability survey showed good internal consistency. NATUTS is a brief survey based on research evidence validated in a large Turkish sample.

CONCLUSION

Findings show that NATUTS has acceptable content and structural validity and is reliable in measuring nurses' attitudes towards the use of telehealth. Further research can be conducted to develop the scale and strengthen its validity.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Development and Validation of Schadenfreude in Bullying and Cyberbullying Scale (SBCS)

BACKGROUND

Schadenfreude is a moral emotion consisting of enjoyment when seeing other people suffer, and whose activation has been related to transgressive behaviour in adulthood. Despite this, the study of this emotion in aggression phenomena among schoolchildren has received little scientific attention, possibly due to a lack of instruments. We aimed to design and provide evidence of the validity and reliability of a scale for measuring schadenfreude in situations of online and offline bullying.

METHODS

The sample consisted of 3,183 primary and secondary school pupils (48.4% girls; M age = 12.76; SD = 1.52).

RESULTS

The data confirmed that the two-dimensional model was the best fit (χ 2 S-B = 81.800; CFI = .984; SRMR = .036; RMSEA = .049). Scale scores were shown to be invariant with regard to gender and age, and evidence was provided of predictive validity, with a clear relationship found between schadenfreude, bullying and cyberbullying.

CONCLUSIONS

These findings confirm the validity of the instrument scores, which may be useful for measuring this emotion in educational contexts and guiding psycho-educational interventions aimed at improving moral emotion regulation and preventing bullying and cyberbullying.

Design and determination of the psychometric properties of a fear of childbirth tool for Iranian adolescent mothers: An exploratory sequential mixed method study protocol

INTRODUCTION

Fear of childbirth (FOC) is a crucial health issue during pregnancy and childbirth, especially among adolescent mothers. Despite emotional, physical and psychological complications of fear of childbirth, perinatal fear and anxiety have been neglected in practice. One reason is the lack of appropriate tools for timely measurement of fear in different target groups. Therefore, researchers have decided to design a fear of childbirth tool and determine its psychometric properties for Iranian teenage mothers on the basis of the cognitive vulnerability model.

METHODS AND ANALYSIS

This exploratory sequential mixed method study will be conducted in two qualitative and quantitative phases. In the qualitative phase, qualitative content analysis is performed on the basis of the cognitive vulnerability model (CVM) via interviews with pregnant adolescent women and up to 6 months after delivery. The data are analyzed according to Elo and Kyngas (2008) in three steps: preparation, organization and reporting. The quantitative phase of the study will be performed in two parts: tool design and psychometrics. We develop the FOC tool according to Waltz et al. (2017). The first step is to select a conceptual model that will be used from the results of the first phase (qualitative method). The next steps include explicating the objectives for the measure, developing the blueprint, and constructing the measure. The psychometrics of the tool will be determined via validity, including content, face and construct validity (exploratory and confirmatory factor analysis), reliability (internal consistency and relative reliability) and responsiveness.

CONCLUSION

Since there is no specific FOC tool for adolescents and the probability of this group being more vulnerable to childbirth, it is necessary to develop a valid tool specifically for adolescents to assess fear of childbirth.

Validating the crèche educator emotional style questionnaire among Chinese kindergarten teachers

Introduction

Kindergarten teachers are important emotional socialization agents for preschoolers' social-emotional competence, and their meta-emotion philosophy might either enhance or inhibit preschoolers' emotional socialization. Due to the lack of relative measurements, no studies have paid much attention to Chinese kindergarten teachers' meta-emotion philosophy.

Methods

The present study included multistage research to evaluate the psychometric properties of the Crèche Educator Emotional Style Questionnaire (CEESQ) among Chinese kindergarten teachers. In Study One, exploratory factor analyses (EFAs) were conducted to assess the factor structure among 535 Chinese preschool teachers. In Study Two, confirmatory factor analyses (CFAs) were performed to confirm the factor structures among 538 other Chinese preschool teachers. The measurement invariance and convergent validity of the Chinese versions of CEESQ were also assessed. The results indicated that the five-factor model was a feasible representation of the Chinese version of CEESQ factor structure (χ2/df = 3.70, CFI = 0.93, TLI = 0.92, RMSEA [90% CI] = 0.061 [0.057, 0.065], RMSEA = 0.05). A multigroup CFA indicated the measurement invariance considering teachers' parenting experiences, amount of teaching experiences, and academic education level.

Results

The Chinese version of CEESQ had robust internal consistency reliability and concurrent validity with emotional intelligence. The Chinese version of CEESQ had sound psychometric characteristics to evaluate Chinese kindergarten teachers' meta-emotion philosophy.

Conclusion

This study added to the existing research literature by supporting the applicability of CEESQ among Chinese kindergarten teachers.

Investigating the psychometric properties of the Persian version of Psychological Emptiness Scale (PES) among nursing students

BACKGROUND

Psychological emptiness plays a significant role in the mental health of nursing students. However, there is currently no valid Persian instrument for measuring psychological emptiness in Iranian nursing students.

AIM

This study aimed to translate and investigate the psychometric properties of the Persian version of the Psychological Emptiness Scale among Iranian nursing students.

METHODS

In this methodological study, after translating and assessing the face and content validity of the Persian version of the Psychological Emptiness Scale, 400 nursing students were selected through proportional quota sampling from four nursing and midwifery colleges affiliated with Birjand University of Medical Sciences in 2024. The factorial structure of the measure was assessed using exploratory factor analysis. Confirmatory factor analysis was then undertaken. Finally, the reliability, including internal consistency and test-retest reliability, and the convergent and divergent validity of the measure were evaluated.

RESULTS

The results of exploratory factor analysis revealed that a three-factor structure accounted for 60.20% of the total variance. The results of the CFA revealed that the three-factor model of the Persian version of the Psychological Emptiness Scale had good or acceptable fit indices. The reliability of the total scale was calculated with a Cronbach's α coefficient of 0.949, McDonald's omega of 0.949, and ICC of 0.840, suggesting acceptable reliability. Results also showed that the convergent and divergent validity of the measure were satisfactory.

CONCLUSION

The findings of this study suggest that the Persian version of the 19-item PES is a reliable and valid instrument for assessing psychological emptiness in Iranian nursing students.

Development and validation of a pictographic assessment embodiment scale

Embodiment is a complex concept related to the subjective perception of an object as it belongs to its own body. In general, this construct has been evaluated by means of questionnaires, but validation studies in other cultures and limitations related with barriers of language received little attention. The purpose of the present investigation was twofold: to validate the factorial structure of embodiment questionnaire (EQ) and to construct a pictographic scale (PAE) to measure embodiment without relapse verbal representations. In the first experiment, 136 participants underwent a Rubber Hand Illusion (RHI) procedure following both congruent and incongruent (control) visuo-tactile stimulations. Then, they evaluated embodiment illusion in EQ using a Likert-type scale to rate their agreement or disagreement with 27 statements and with a pictographic scale designed to assess their subjective experience of the illusion. Principal components analysis in EQ scores identified four components that emerged in both conditions: Embodiment, Disembodiment, Affect and Deafference. PAE scale was highly correlated with embodiment factor and can differentiate between conditions. In a second experiment, 30 participants underwent the RHI procedure, and they were assessed using PAE and proprioceptive drift. Results indicate a high positive correlation between PAE and post-illusion drift score. These results provide evidence about the consistency of the factorial structure of EQ across cultures, and we also provide a new pictographic tool that allows quick measurement of embodiment overcoming language barriers.

Development of the Perceived Challenges in Disaster Response Scale (PCDRS): Validity and Reliability Study

OBJECTIVES

This study aimed to design and validate a measurement tool in Turkish to assess the challenges perceived by individuals involved in the disaster response process, such as volunteers, health care personnel, firefighters, and members of nongovernmental organizations (NGOs).

METHODS

This methodological study was conducted from November 2023 through March 2024. The scale development process comprised item development, expert reviews, and language control, followed by the creation of a draft survey, pilot testing, application of the final scale, and statistical analyses. All stages, including validity and reliability analyses, were conducted in Turkish. While reliability analysis used Cronbach's alpha, item-total correlations, intraclass correlation coefficients, test-retest reliability, Tukey's additivity, and Hotelling's T-squared tests, validity analysis included Exploratory and Confirmatory Factor Analyses (EFA/CFA). Software such as AMOS 22.0 and SPSS 22.0 were used to perform statistical analysis.

RESULTS

Findings indicated six dimensions with 23 items, with factor loadings ranging from 0.478 to 0.881. The CFA demonstrated acceptable fit indices. Test-retest analysis showed a robust positive correlation (r = 0.962) between the measurements. The scale's total Cronbach's alpha coefficient was 0.913. Sub-dimension reliability scores were calculated as follows: 0.865 for environmental and health, 0.802 for communication and information, 0.738 for organizational, 0.728 for logistical, 0.725 for individual, and 0.809 for other factors.

CONCLUSIONS

This study showed that the Perceived Challenges in Disaster Response Scale (PCDRS), developed and validated in Turkish, is a reliable and valid measurement tool. It offers a foundation for understanding the challenges faced by disaster response teams and for formulating improvement strategies.

Psychometric properties of the Brief Mishel Uncertainty in illness scales for patients with advanced cancer and their family caregivers

BACKGROUND

This study comprehensively examined the psychometric properties of the Brief Mishel Uncertainty in Illness Scale for patients (MUIS-P) managing advanced cancer and their caregivers (MUIS-Cg).

METHODS

The MUIS-P and MUIS-Cg scales were developed based on the Mishel Uncertainty in Illness Scale-Adult. We conducted a secondary analysis to test the acceptability, factor structure, reliability, and validity of the brief uncertainty scales for patients with advanced cancer (N = 484) and their caregivers (N = 484) using data from a randomized clinical trial.

RESULTS

The 9-item MUIS-P and MUIS-Cg show goodness of fit for a two-factor structure (unpredictability and ambiguity) with adequate to acceptable internal consistency (Cronbach's alpha 0.66-0.78 for patients and 0.70-0.72 for caregivers and McDonald's omega 0.72-0.84 for patients and 0.76-0.79 for caregivers). The MUIS-P and MUIS-Cg scores correlated with negative appraisals of illness/caregiving, hopelessness, and avoidant coping, demonstrating convergent validity. The discriminant validity of the MUIS-P and MUIS-Cg was evidenced by their significant correlations with self-efficacy and active coping. The baseline MUIS-P and MUIS-Cg scores were significantly associated with quality of life, hopelessness, depression, distress, and avoidant coping at the 3-month follow-up, indicating their strong predictive validity.

CONCLUSION

This study comprehensively evaluated the psychometric properties of the MUIS-P and MUIS-Cg, laying a foundation for their use in research and clinical practice among patients and caregivers managing demanding symptoms and care.

Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors

BACKGROUND

In recent decades, mental health and stress among medical students have become a global concern. Currently, China lacks a scale specifically designed to assess stress levels in medical school settings. This study aims to cross-culturally translate and adapt the Perceived Medical School Stress (PMSS) Scale into Chinese, evaluate its psychometric properties in medical schools, and analyze the associated factors of medical students' stress levels.

METHODS

Data collection for the Chinese version of the PMSS was conducted from October to November 2023, among medical students from selected medical schools in North and East China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the underlying factor structure. Content validity was assessed using the Content Validity Index (CVI). Criterion validity was evaluated with the Chinese version of the Perceived Stress Scale (PSS). Internal consistency was assessed by calculating Cronbach's alpha coefficient, McDonald's Omega coefficient, and test-retest reliability. Additionally, relationships between medical school stress and general demographic characteristics, insomnia severity, and self-efficacy were examined.

RESULTS

The final Chinese version of the PMSS supports a two-factor structure with 13 items, defined as "psychological stress and environment" and "resilience and expectations." The scale's Content Validity Index (CVI) was 0.980, with a criterion validity of 0.767. The Cronbach's alpha coefficient was 0.911, McDonald's Omega coefficient was 0.914, and the test-retest reliability was 0.794. Medical school stress levels showed significant differences based on gender and educational background (P < 0.05). Stress levels were positively correlated with insomnia severity and negatively correlated with self-efficacy.

CONCLUSIONS

The Chinese version of the PMSS is a reliable and valid tool for assessing stress levels among medical students in Chinese medical schools. Female students and those pursuing graduate degrees report higher levels of medical stress. Insomnia severity and self-efficacy significantly influence stress levels among medical students.

General medication adherence scale in patients with chronic illnesses: Persian translation and psychometric evaluation

ObjectivesThis study was conducted with the aim of determining the validity and reliability of the Persian version of "General Medication Adherence Scale (GMAS)" in chronic patients in Iran.MethodologyThe study was conducted among patients with chronic diseases in five hospitals of Iran. In this study, after cultural validation, using the steps of Content, Response Reaction, and Internal structure evaluations, the research sample was increased to 150 individuals for exploratory factor analysis (EFA) and 313 chronic patients for confirmatory factor analysis (CFA) to confirm the construct validity. Cronbach's alpha coefficient was used to assess internal consistency, and test-retest method was used to evaluate the reliability of the tool.FindingsThe results of EFA and CFA confirmed the tool with three factors and 11 items. The R2 index in the above model was estimated at 0.99, indicating that 99% of the variation in medication adherence scores in research units was explained by GMAS with 11 items. The main indices of the model in factor analysis were all above 0.9, indicating a good fit for the model.DiscussionOverall, the study results showed that the Persian version of GMAS has acceptable and practical characteristics for evaluating medication adherence, and it can be used as a valid tool in various related fields.

Development of the ethical decision-making competence scale

BACKGROUND

Developing confident capacity for ethical decision-making is vital in nursing education. However, no tool examines nursing students' competence in ethical decision-making.

AIM

This study aimed to develop an Ethical Decision-Making Competence Scale (EDM-CS) to assess ethical care decision-making competencies in nursing students.

PARTICIPANTS AND RESEARCH CONTEXT

Original items were obtained by employing a focus group and the Delphi method. A cross-sectional design was used to confirm the items remained on the scale. Additionally, the scale's reliability and validity were assessed. The EDM-CS was completed by 498 nursing students. An exploratory factor analysis (EFA) was used to examine the factor structure based on data from group 1 (n = 250). A second-order confirmatory factor analysis (CFA) was used to examine the model's fitness based on data from group 2 (n = 248). This study was conducted between August 2022 and July 2023.

ETHICAL CONSIDERATIONS

The Institutional Review Board of Chung Shan Medical University Hospital approved this study's design and procedure.

RESULTS

From the original 34 items, nine were deleted in the EFA. Thus, the EDM-CS had 25 items and a four-factor structure (ethical judgement, ethical sensitivity, ethical motivation, and ethical action), which explained 60.97% of the total variance. A second-order CFA identified a second-order factor termed 'ethical decision-making competence' with 18 items (root mean square residual = 0.052). The EDM-CS scores correlated significantly and positively with the scores on the Scale of Protective Factor-24 (r = 0.47, p < .001), which indicated good convergent validity. Cronbach's alpha coefficient of the final EDM-CS was 0.90 and ranged from 0.73 to 0.80 for the four subscales.

DISCUSSION AND CONCLUSION

The EDM-CS was validated to fit the data adequately. It can be used to evaluate clinical nursing students' ethical decision-making abilities and to develop education strategies to improve their ethical care competence.

Translation and cultural adaption of MacLeod Clark professional identity scale among Chinese therapy students

BACKGROUND

Fostering a strong professional identity (PI) enhances career fulfillment. In China, therapy education is undergoing development, integrating both Western and traditional health concepts, causing inconsistent PI among therapy students. To date, no validated tools exist to measure and monitor PI of Chinese therapy students. This study aimed to translate and validate the 9-item MacLeod Clark Professional Identity Scale (MCPIS-9) for this purpose.

DESIGN

This study involved translation and cultural adaptation of the MCPIS-9, followed by a rigorous assessment of its model fit and psychometric properties using data collected via an online questionnaire.

METHODS

A forward- and backward- translation process was conducted. Content validity was evaluated using item-level content validity index (I-CVI) and scale level content validity index average method (S-CVI/Ave). Therapy students across all grades at undergraduate and postgraduate levels in China were eligible. Exploratory factor analysis (EFA) examined the underlying factor structure. Model fit was evaluated through confirmatory factor analysis (CFA) using the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR) and Root Mean Square of Error of Approximation (RMSEA). Convergent validity was assessed through Pearson's correlations coefficient (r) with the Professional Identity Scale for Health Students and Professionals (PISHSP). Internal consistency was examined using Cronbach's Alpha (Cα) and McDonald's Omega (ω).

RESULTS

A total of 1054 students participated. Content validity was excellent (I-CVI = 0.86-1.0, S-CVI/Ave = 0.98). EFA indicated a two-factor structure with acceptable model fit (CFI = 0.978; TLI = 0.968; SRMR = 0.033; RMSEA = 0.063). Reliability was strong (Cα = 0.835; ω = 0.817). Convergent validity demonstrated a strong correlation (r = 0.75) with the PISHSP.

CONCLUSIONS

The Chinese MCPIS-9 is a reliable and valid tool for assessing PI among therapy students. Future research could focus on refining item 4 of this tool, potentially through further exploration of therapy students' perceptions of PI within the unique context of the Chinese healthcare system.

Translating, Adapting and Validating the Revised MISSCARE Survey for Use in Norwegian Hospitals-A Pilot Study

Background

The original MISSCARE Survey was developed in the US in the early 2000s to assess the amount of missed nursing care. Because additional causes of missed care were detected in later years, the MISSCARE Survey was further developed in 2019 by adding one item in Part A and five items in Part B to the questionnaire. Neither the original nor the revised MISSCARE Survey is translated into Norwegian, so a questionnaire is needed to assess missed nursing care in Norway. This study aims to translate and adapt the revised MISSCARE Survey for use in Norwegian hospitals.

Methods

A forward translation, followed by an expert panel's back-translation, cognitive interviews, and final version testing were conducted. Exploratory factor analyses were conducted to investigate the underlying factor structure. Internal consistency was assessed using Cronbach's alpha, and the intraclass correlation coefficient (ICC) was employed for a test-retest evaluation. IBM SPSS Statistics (version 29) was used for all analyses.

Results

A total of 120 nurses and nursing assistants took part in the study assessing the psychometric properties of the Norwegian adaptation of the revised MISSCARE Survey. The exploratory factor analysis for Part B revealed four factors, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.895, and Cronbach's alpha values ranged from 0.841 to 0.751, reflecting good internal consistency. The overall test-retest ICC was 0.894 for Part A and 0.827 for Part B, indicating strong reliability.

Conclusions

The revised MISSCARE Survey adapted for use in Norwegian hospitals is a reliable and promising instrument for assessing missed nursing care in medical and surgical units within a local Norwegian hospital. However, further studies should be conducted to confirm the factor structure in larger and more diverse populations.

Psychometric evaluation of the System Usability Scale in the context of a childrearing app co-designed for low- and middle-income countries

Objective

The System Usability Scale (SUS) demonstrates good psychometric properties for a range of technologies; however, its reliability and factor structure in the context of a childrearing application (app) and variation across cultures remains largely unexplored. This study investigates the reliability and factor structure of the SUS in the context of a childrearing app that was co-designed for and implemented in diverse low- and middle-income countries (LMICs).

Methods

Parents and caregivers of children aged 0-5 years in five LMICs completed the SUS after having access to the app for a minimum of 2 and maximum of 24 weeks. Survey data from participants (n = 668) was analysed using exploratory and confirmatory factor analysis methods.

Results

The bi-factor model shows the best fit to data (comparative fit index = 0.998; Tucker Lewis Index = 0.996; standardised root mean square residual = 0.033). Further analysis suggests that usability and learnability subscales provide additional information not contained in the total SUS score. A two-sample t-test shows that younger caregivers, employed full- or part-time, and with fewer children reported significantly better app usability.

Conclusion

The SUS has good psychometric properties, and it is a valid and reliable tool for assessing the usability of mobile apps when used by parents and other caregivers for children's socioemotional and cognitive development. However, it is not essentially unidimensional and appears to have a multidimensional structure that could be specific to our context owing to variations in users' experience, culture, and language. The findings have implications for other mobile health interventions implemented in contexts with cultural and linguistic differences.

Confirmatory validation of the transgender health care humanization scale

BACKGROUND

Despite the critical importance of humanized healthcare for transgender individuals, no existing measures specifically assess care humanization for this population. The Transgender Health Care Humanization Scale (THcH Scale) was developed to address this gap, yet it initially lacked confirmatory validation. This study validates the Transgender THcH scale for evaluating healthcare providers' sensitivity towards transgender patients.

METHODS

This study involved 443 healthcare professionals and students from a public university and associated hospital. Participants were divided randomly into two groups for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett's Test of Sphericity, EFA confirmed data suitability for factor analysis. Factors were identified using parallel analysis with an oblique Promax rotation to allow for inter-factor correlations. The internal consistency of the factors was assessed using Cronbach's alpha. CFA was performed using Maximum Likelihood estimation, with goodness-of-fit evaluated by multiple indices. The THcH Scale's divergent validity was assessed through Spearman's correlation analysis with the Duke University Religion Index (DUREL).

RESULTS

Exploratory and Confirmatory Factor Analyses confirmed the scale's two-factor structure with excellent psychometric properties, including high internal consistency (Cronbach's alpha > 0.8) and good fit indices (χ²/df = 1.74, CFI = 0.972, TLI = 0.964, GFI = 0.989, RMSEA = 0.069, SRMR = 0.043). Divergent validity was established through moderate correlations with the DUREL index.

CONCLUSIONS

The THcH scale is a reliable and valid tool for promoting sensitivity and awareness among healthcare professionals, thereby enhancing healthcare access and quality for the transgender population. Further research should expand its application to primary care and diverse populations and settings.

Feel the Fear and Do It Anyway-Beliefs About Compassion Predict Care and Motivation to Help Among Healthcare Professionals

AIMS

To develop and preliminarily validate a measure of beliefs about compassion in health care and assess whether and which beliefs may predict compassion.

DESIGN

Pre-registered cross-sectional online survey study with a repeated-measures vignette component.

METHOD

Exploratory and Confirmatory Factor analyses were performed on a split sample of 890 healthcare professionals in Aotearoa New Zealand (NZ). Links with fears of compassion for others, burnout, trait compassion, compassion competency and ability and self-efficacy were used to assess convergent and divergent validity. Linear mixed model regression analyses were used to assess relationships between beliefs and compassion. In writing this report, we adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

RESULTS

Four-factor structure featuring three negative (compassion as harmful, not useful, draining) and one positive (compassion is important) type of beliefs was established. Confirmatory factor analysis indicated a good fit and subscales indicated good measures of validity. Internal consistency was achieved for the subset of beliefs (harmful, not useful). Regression analyses indicated negative effects of the belief that compassion is draining on caring, motivation to help and compassion overall; negative effects of the belief that compassion is not useful on the motivation to help and a positive effect of the belief that compassion is important on caring and compassion overall. There was no effect of beliefs that compassion is harmful on compassion measures.

CONCLUSION

This report extends prior qualitative studies of beliefs about compassion in a large healthcare sample, offering a way to measure these potentially malleable factors that might be targeted in education, interventions and future research.

PATIENT OR PUBLIC CONTRIBUTION

The study was designed in consultation with healthcare and compassion research professionals, including substantial input from Indigenous Māori healthcare professionals.

The Chinese version of the Nursing Student Academic Resilience Inventory: A validity and reliability study

AIM

To translate and adapt the Nursing Student Academic Resilience Inventory (NSARI) into Chinese and assess its validity and reliability among Chinese nursing students.

BACKGROUND

Nursing students frequently encounter stress during their clinical education and academic resilience is an important skill to help students withstand stress. The NSARI is a valid and reliable tool for assessing the level of academic resilience of nursing students during clinical practice. Currently, there is no valid and reliable measurement tool to assess academic resilience for nursing students in China.

DESIGN

A descriptive, methodological and cross-sectional design was used.

METHOD

This study was conducted on 600 nursing students in Northeast China. A socio-demographic form, the Chinese version of the NSARI and the nurse resilience scale were used for data collection between May to November 2023. The exploratory factor analysis and confirmatory factor analysis samples comprised 300 students, respectively, to test the structural validity of the inventory. In addition, internal consistency and invariance analyses were conducted to assess the reliability of the inventory.

RESULTS

The Chinese version of NSARI comprises 24 items separated into six dimensions. Exploratory factor analysis extracted six factors, with a cumulative variance contribution rate of 71.908 %. Confirmatory factor analysis showed a satisfactory fit. Cronbach's alpha coefficient for the internal consistency of the total inventory was 0.939 with a test-retest stability reliability value of 0.957.

CONCLUSION

The Chinese version of NSARI is a valid and reliable measurement tool for assessing the level of academic resilience of nursing students during clinical placement.

Measuring Cardiovascular Disease Risk Perception: Translation and Validation of the Indonesian ABCD Risk Questionnaire

Background

Cardiovascular diseases (CVDs) are still increasing worldwide contributing to increasing death worldwide. To test CVDs' awareness, the Attitude and Belief about Cardiovascular Disease (ABCD) questionnaire was developed. However, this questionnaire is not available in Indonesia language.

Methods

The original questionnaire was translated in both directions forward and backward. The process is then continued with a content validity index created by three experts. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) then determine the factors that support the translated questionnaire. The splitting sample method was applied in both factor analyses. Internal consistency testing of 18 items was performed on 236 samples.

Result

The validity of the entire questionnaire subscale was satisfactory. Three retained factors were supported by the EFA and CFA, namely, risk perception, perceived benefit, and healthy eating intention. The internal consistency was acceptable based on Cronbach alpha and ordinal alpha. The Indonesian version of ABCD questionnaire was statistically valid and reliable to be used.

Conclusion

The Indonesian version of the ABCD questionnaire is a valid questionnaire to access the attitude and belief of CVDs in Indonesia.

A Relative Normed Effect-Size Difference Index for Determining the Number of Common Factors in Exploratory Solutions

Descriptive fit indices that do not require a formal statistical basis and do not specifically depend on a given estimation criterion are useful as auxiliary devices for judging the appropriateness of unrestricted or exploratory factor analytical (UFA) solutions, when the problem is to decide the most appropriate number of common factors. While overall indices of this type are well known in UFA applications, especially those intended for item analysis, difference indices are much more scarce. Recently, Raykov and collaborators proposed a family of effect-size-type descriptive difference indices that are promising for UFA applications. As a starting point, we considered the simplest measure of this family, which (a) can be viewed as absolute and (b) from which only tentative cutoffs and reference values have been provided so far. In this situation, this article has three aims. The first is to propose a relative version of Raykov's effect-size measure, intended to be used as a complement of the original measure, in which the increase in explained common variance is related to the overall prior estimated amount of common factor variance. The second is to establish reference values for both indices in item-analysis scenarios using simulation. And the third aim (instrumental) is to implement the proposal in both R language and a well-known non-commercial factor analysis program. The functioning and usefulness of the proposal is illustrated using an existing empirical dataset.

Psychometric Properties of the Arabic Version of the Pain Resilience Scale among Lebanese Adults with Chronic Musculoskeletal Pain

Background

The Pain Resilience Scale (PRS), which measures behavioral perseverance and the ability to regulate emotions and cognition despite ongoing pain, lacks an Arabic version.

Objectives

This study aimed to translate, culturally adapt, and validate an Arabic version of the Pain Resilience Scale (PRS-A) among Lebanese adults.

Methods

Phase 1 involved translation and cross-cultural adaptation of the PRS into Arabic. Phase 2 examined the reliability and validity of the PRS-A. A convenience sample of 154 Lebanese adults with chronic musculoskeletal pain completed the PRS-A and self-report measures of pain catastrophizing, pain self-efficacy, pain intensity and interference, depression and anxiety, and quality of life.

Results

The PRS-A yielded a two-factor structure with factor 1 representing "cognitive/affective positivity" and factor 2 representing "behavioral perseverance," accounting for 41.93% and 15.15% of the variance in pain resilience, respectively. Total PRS-A score (M = 33.20 and SD = 9.90) showed significant correlations with pain catastrophizing (M = 27.65, SD = 13.03, and r = -0.52), pain self-efficacy (median = 9.00, IQR = 4, and rho = 0.61), pain intensity (M = 4.50, SD = 2.25, and r = -0.28), pain interference (M = 4.30, SD = 2.89, and r = -0.56), physical (M = 34.95, SD = 9.52, and r = 0.34) and mental (M = 40.08, SD = 12.49, and r = 0.58) health functioning, anxiety (median = 7.00, IQR = 7, and rho = -0.57), and depression (median = 4.00, IQR = 6, and rho = -0.58). PRS-A subscale was also significantly related to all measures except pain intensity, which was correlated with cognitive/affective positivity (r = -0.33) but not behavioral perseverance (r = -0.09). Cronbach's alpha for the PRS-A was 0.87.

Conclusion

The PRS-A demonstrated validity and acceptable reliability among Arab-speaking individuals with chronic musculoskeletal pain, suggesting its potential utility for assessing pain resilience within this population.

Music performance anxiety: development and validation of the Portuguese music performance anxiety scale

Several studies have developed and validated specific scales to understand, identify and confirm research hypotheses associated with music performance anxiety (MPA). These scales mostly assess behavioral, cognitive, and physiological factors. There is currently no original MPA assessment tool for higher music education in Continental Portuguese, which suggests a research gap. The aim of this study was to determine if the Portuguese Music Performance Anxiety Scale (PoMPAS), developed for this research, is a valid and reliable measure of MPA for the context of higher education in Portugal. The total sample was N = 414 (166 male, 245 female, and three without gender identification). The development of this scale was based on a three-dimensional model (behavioral, cognitive, and physiological), following the theoretical models of Salmon (1990) and Osborne and Kenny (2005). Confirmatory factor analysis of the PoMPAS suggested a good fit in a three-dimensional model with 27 items. The internal consistency values proved appropriate, showing good Cronbach's alphas (between α = 0.81 and α = 0.90). The McDonald's Omega also demonstrated good consistency (between ω = 0.81 and ω = 0.90). The PoMPAS is a reliable tool to measure the impact of MPA, with good psychometric qualities, specifically for the Portuguese higher music education context.

Development and validation of the self-consciousness type scale

Introduction

Previous research has highlighted the duality of self-consciousness, which simultaneously plays adaptive and maladaptive roles. This study aims to develop a measure that categorically distinguishes between different types of self-consciousness styles based on the Regulatory Focus Theory (RFT) and examines their relationship with mental health-related indicators.

Methods

Data were gathered through an online mental health survey conducted at a University Student Counseling Center in Seoul. The study involved exploratory factor analysis, confirmatory factor analysis, and reliability and validity analysis, which resulted in the development of a 14-question Self-Consciousness Type Scale (SCTS).

Results

Both exploratory and confirmatory factor analyses validated the two-factor structure of the SCTS. The fit indices of the final model indicated a good fit, with high internal consistency for both sub-factors. Convergent and discriminant validity were confirmed through correlations between the sub-scales. Cluster analysis identified four distinct subtypes of self-consciousness styles: Growth-oriented, Defensive, Ambivalent, and Low-focus self-consciousness. Group difference analysis revealed significant differences in mental health-related variables among the subtypes, supporting the 2 × 2 model of prevention-focused and promotion-focused self-consciousness.

Discussion

The findings support the SCTS as a valid measurement tool capable of distinguishing four distinct types of self-consciousness, aligning with the multidimensional model of self-consciousness. The study's limitations and implications were discussed based on the results, emphasizing the potential applications of the SCTS in mental health research and practice.

Is it time to replace the Big Five personality model? Factorial structure of the NEO PI-R in a community sample of Spanish adults

Recent studies have revived the issue of whether the five-factor personality model or Big Five is the most valid to summarize the most relevant personality traits or whether, on the contrary, the basic structure of personality traits would better fit a six-factor model such as the HEXACO model: Honesty-Humility (H), Emotionality (E), Extraversion (X), Agreeableness (A), Conscientiousness (C), and Openness to Experience (O). In a Spanish community sample of 682 adults, the factorial structure of the 30 facets of the NEO-Revised Personality Inventory (NEO PI-R) and its 16 facets common to the HEXACO model was analyzed. In two subsamples of participants, the internal structure of the NEO PI-R, of 30 and 16 facets, fit the five-factor Big Five model better than the six-factor HEXACO model. In addition, the internal 30-facet structure of the NEO-PI-R replicated that obtained in the original US validation and those previously obtained in Spain, although the latter used different participant samples (people evaluated in personnel selection processes, university students). These results suggest that, at least in Spain, the five-factor personality model or Big Five is still the most valid taxonomy of personality traits.

Construct validity and reliability of the BARRIERS scale in the Spanish context

OBJECTIVE

To establish the construct validity of the Spanish version of the BARRIERS scale.

METHOD

Methodological study of validation of a measurement instrument based on data from previously published studies. The study population consisted of nurses from the Basque Health Service and the Canary Health Service. The following variables were extracted and unified: Years of professional experience, possession of a specialist nursing degree, possession of a doctorate, type of activity performed by the professional and field of work. For construct validation, a confirmatory factor analysis (CFA) was performed based on the initial model proposed for the scale and RASCH analysis. A polychoric correlation matrix, factor extraction by unweighted least squares and PROMIN oblique rotation were used. For the RASCH analysis, the Joint Maximun Likelihood estimation (JMLE) method was used; the fit of the items and persons were estimated by means of outfit - Unweighted Mean Square fit statistic (UMS) and infit -Weighted Mean Square Fit Statistic (WMS), as well as the reliability and separation of items and persons.

RESULTS

A total of 1200 nurses and midwives made up the final validation sample (n = 1200), with a mean professional experience of 21.22 ± 9.26 years. The CFA presented a good fit to the data (KMO = 0.935 [95% CI: 0.921-0.945]), changing the factorial assignment in 6 items, while 5 items received factorial scores in more than one factor. The fit values for the 4-factor solution were RMSEA = 0.026 [95% CI: 0.026-0.027] and GFI = 0.991 [95% CI: 0.986-0.991]. In the RASCH analysis most items presented infit-WMS and outfit-UMS values with a good fit.

CONCLUSIONS

The Spanish version of the BARRIERS scale has adequate construct validity although there are changes in the assignment of items to the dimensions compared to the original model. The RASCH analysis indicates adequate fit for both persons and items.

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.

Endorsement of metaphysical idealism mediates a link between past use of psychedelics and wellbeing

It has been proposed that psychedelics promote wellbeing through spiritual-type transformations, involving changes in metaphysical beliefs. Past empirical research shows a link between the use of psychedelics and the endorsement of non-physicalist metaphysical beliefs. However, non-physicalist beliefs encompass a wide range of metaphysical ideas, and their links to wellbeing and psychedelics use remain unclear. We utilized a cross-sectional Internet survey to probe the metaphysical beliefs of participants (N = 701) with past experience of classical psychedelics, using a novel 42-item questionnaire (Core Metaphysical Beliefs, CMB), encompassing a wide range of metaphysical beliefs. Factor analysis of CMB revealed two factors, Idealism and Materialism. In network analyses, Idealism was linked to psychological insight in a past psychedelic experience (E = 0.24) and average use of psychedelics (E = 0.16), and predicted wellbeing (Es = 0.13 and 0.22). Mediation analyses showed an indirect link from past psychedelics use through Idealism to wellbeing (ps ≤ .005). Non-Physicalist Beliefs or Materialism were not significant mediators. The results indicate that Idealism specifically, not non-physicalist beliefs generally, mediate a link between the use of psychedelics and wellbeing. Future research is required to establish whether the link is causal, and to understand what the Idealism factor means.

Development and validation of a short clinical risk management implementation (Short CRiMI) questionnaire

Clinical Risk Management (CRM) is an important instrument to continuously improve safety of health care delivery. In Germany, hospitals are required by law to implement CRM and incidence reporting systems. Since 2010, nation-wide surveys have been conducted periodically to evaluate implementation of CRM in hospitals. The instrument used in these surveys is constantly being updated to reflect previous experiences, as well as to adapt to ongoing trends and developments in CRM practices. The survey instrument used in 2022 consisted of up to 200 items and took up to an hour to complete. In this study, we aimed to develop a short instrument to measure the level of CRM implementation in hospitals, evaluate its psychometric properties, and to offer benchmarking data for health care facilities of different sizes. We used data collected in 2022 as part of KHaSiMiR study, employing a cross-sectional self-reported online survey. The hospital administrations were invited to designate one CRM manager to participate in the study. Out of 1,411 general hospitals invited, 401 responses were collected (response rate of 28%). After removing the cases with excessive missings, we imputed remaining missing values using multiple imputation, and split the resulting sample (n=362) in two halves (i.e., exploratory and testing subsamples). A principal component analysis was applied on the first subsample. We validated the resulting model using confirmatory factor analysis in the testing subsample. We evaluated internal consistency, and tested external validity of the established instrument using correlation analysis with two single-item measures: subjective evaluation of CRM implementation compared to similar organizations and compared to own ideal level. The principal component analysis included 45 items from the full instrument. The analysis resulted in a three-factor model with 26 items. In the confirmatory factor analysis, the model demonstrated acceptable fit with the data according to the commonly used fit indices: Chi2/df=1.36, CFI=0.941, TLI=0.930, RMSEA=0.045 (90% CI=0.032-0.056), SRMR=0.049. Cronbach's alpha of all three factors was good (>0.70). All three factors had statistically significant positive correlations with each other (0.359-0.497) and with the two single items (0.282-0.532). None of the correlations were high enough (>0.7) to indicate multicollinearity. The proposed short clinical risk management implementation (Short CRiMI) questionnaire is psychometrically valid and can be used to rapidly evaluate CRM implementation in hospitals. Further research can provide evidence of its external validity and association with quality and safety outcomes. Benchmarking data can be used to compare the results with the data from the most recent Germany-wide survey.

Évaluation de la structure factorielle et des qualités psychométriques de l'Échelle de Fatigue Pandémique parmi la population adulte québécoise: Evaluation of the factorial structure and psychometric qualities of the Pandemic Fatigue Scale among Quebec adult population

OBJECTIVE

The objective of the study is to evaluate the factorial structure and the psychometric qualities of the Pandemic Fatigue Scale among the Quebec adult population.

METHOD

The data analyzed come from a web survey conducted in October 2021 among 10 368 adults residing in Quebec. The scale's factor structure and invariance by gender, age and language used to complete the questionnaire were tested using confirmatory factor analyses. Convergent and divergent validity were also assessed. Finally, the reliability of the scale was estimated from the alpha and omega coefficients.

RESULTS

The analyzes suggest the presence of a bidimensional structure in the sample of Quebec adults with informational fatigue and behavioral fatigue. The invariance of the measure is noted for sex, for age subgroups and for the language used for the questionnaire. The results of convergent and divergent validity provide additional evidence for the validity of the scale. Finally, the reliability of the scale scores is excellent.

CONCLUSION

The results support the presence of a bidimensional structure as in the initial work of Lilleholt et al. They also confirm that the scale has good psychometric qualities and that it can be used among the adult population of Quebec.

Spanish Adaptation and Psychometric Properties of the Protective Behavioral Strategies for Marijuana Scale: The Protective Behavioral Strategies for Cannabis Scale (S-PBSC)

The Protective Behavioral Strategies for Marijuana scale (PBSM) was initially developed using samples of university students in USA. A community sample of Spanish young adults was recruited to provide the Spanish full-length and short versions of the Protective Behavioral Strategies for Cannabis use (S-PBSC; S-PBSC-SF). We followed a rigorous item-selection process to select the most relevant items from the original 50-item pool developed by Pedersen et al. (2016), on the basis of evidence of reliability, evidence of validity according to the internal structure (factor loadings, invariance across genders and university status, and differential item functioning [DIF]), and evidence of validity based on the relationships between S-PBSC scores and cannabis outcomes. Our findings support a 31-item unidimensional measure and a 13-item short form with excellent fit and internal consistency, invariant across genders and college status and free of DIF. Both the S-PBSC and S-PBSC-SF scores were associated with reduced cannabis use and consequences.

Integral leadership in nursing: Development and psychometric validation of a Korean version of the Integral Nursing Leadership Scale

BACKGROUND

With the importance of nursing leadership roles, there is a need for a more integrated approach to nursing leadership that can adapt quickly to many challenges in today's healthcare environments. In recent years, integral leadership that can apply a more holistic and inclusive approach to leadership has gained growing attention in other disciplines. However, research on integral leadership in nursing is sparse since no instrument specifically measuring integral leadership in nursing contexts is available.

OBJECTIVE

The study aimed to develop an integral nursing leadership scale and evaluate its psychometric properties.

METHODS

The scale was developed in two phases. In the first phase, items were generated to reflect the attributes of integral leadership in the nursing context. These attributes were identified through a conceptualization process using a literature review and semi-structured interviews. The process was based on the four dimensions of the integral leadership framework, adopting Wilber's four quadrants of integral theory. Then, the psychometric properties of the scale, including content validity, structural validity, and internal consistency reliability, were evaluated. Data were collected from a convenience sample of 806 Korean nurses and were analyzed using both exploratory factor analysis and second-order confirmatory factor analysis, using two separate random halves of the sample.

RESULTS

The newly developed scale consisted of 30 items across four dimensions: individual leadership qualities, individual performance, influencing organizational culture, and organizational excellence. Content validity for the 30 items was calculated to be 0.84 for item-level content validity and 0.96 for the scale's content validity averaging method, indicating adequate content validity. The four-factor structure of integral nursing leadership was cross-validated by exploratory factor analysis and second-order confirmatory factor analysis. The internal consistency reliability was also found to be acceptable, as indicated by a Cronbach's alpha of 0.97 and a McDonald's ω estimate of 0.98.

CONCLUSION

Findings demonstrate that the Integral Nursing Leadership Scale has acceptable content validity, structural validity, and reliability in measuring integral leadership, specifically in the context of nursing. More research is needed to further refine and establish strong validity of the scale.

Children's perception of food parenting practices: adaptation and validation of the comprehensive feeding practices questionnaire in Chilean adolescents

Introduction

Assessment of the Comprehensive Feeding Practices Questionnaire in adolescents (CFPQ-Teen) is still limited, with no evaluation of the measurement invariance. The participants comprised 473 Chilean adolescents of both sexes from dual-income nuclear families. The aims of this study were: (1) to adapt to Spanish and validate a model of five-factor version the CFPQ-Teen; (2) to examine the psychometric properties, (3) to evaluate the measurement invariance according to the adolescents' gender; and (4) to compare the scores of each factor between female and male adolescents.

Methods

The instrument was translated, back-translated, and adapted from the CFPQ-Teen, confirming the equivalence, conceptual, and face validity in a pilot sample of 40 adolescents. An exploratory factor analysis was performed on the five-factor model of the CFPQ-Teen: Monitoring, Adolescent Control, Restriction for weight control, Parental Modeling, and Environment. The Environment factor was eliminated as a result.

Results

The confirmatory factor analysis presented good reliability, convergent, discriminant, and concurrent validity values. In addition, medium to high goodness-of-fit levels were obtained by eliminating an item from the Adolescent Control factor. These results confirm a final 20-item model representing four factors. The multigroup invariance analysis of the measurement model verified configural, metric, scalar, and partial strict invariance. No significant differences were found between females and males in the scores on the four factors.

Discussion

These results enable comparisons by sex on the perceptions of Food Parenting Practices from the analyzed factors, primarily within the context of the Chilean sample.

Psychometric properties of the family assessment task parental monitoring scenario among adolescents receiving substance use treatment

INTRODUCTION

The Family Assessment Task (FAsTask) is an observer-rated parent-child interaction task used in adolescent substance use intervention. The parental monitoring component of the FAsTask is thought to provide an objective assessment of parental monitoring that can guide treatment planning and circumvent the potential limitations of self-report measures. Yet, the factor structure, measurement invariance, and concurrent validity of the parental monitoring FAsTask has not been evaluated; doing so is essential to effectively guide clinical care. This study examined if the parental monitoring FAsTask can be reliably administered across adolescent age and sex, and to identify which components of the parental monitoring FAsTask are most consistently associated with adolescent substance use.

METHODS

The study pooled data from 388 adolescent-caregiver dyads across six separate clinical trials (adolescents [Mage = 15.7, 57.5% male, 61.9% White, 31.2% Latine]; caregivers [Mage = 42.14, 88.7% female, 72.7% White, 24.2% Latine]). Dyads completed the FAsTask and the Timeline Followback at baseline, prior to randomization. Analyses proceeded in three steps. First, exploratory factor analysis (EFA) was conducted in half of the sample, followed by a confirmatory factor analysis (CFA) in the second half of the sample. Second, measurement invariance was tested as a function of adolescent age and biological sex. Third, a series of structural equation models were used to assess the associations of each factor with alcohol use, binge drinking, and cannabis use.

RESULTS

EFA and CFA indicated the presence of four factors (labeled Supervised/Structured, Active Monitoring, Task Engagement, and Parental Rules/Strategies). Evidence of measurement invariance was found across adolescent age and sex. The Supervision/Structure was negatively associated with adolescent alcohol use, binge drinking, and cannabis use.

CONCLUSIONS

The parental monitoring FAsTask demonstrates validity and retains its structure across adolescent age and sex. Items focused on parental supervision and structure are most strongly associated with adolescent substance use and may best inform clinical care for adolescent substance use.

Improved estimation of general cognitive ability and its neural correlates with a large battery of cognitive tasks

Elucidating the neural mechanisms of general cognitive ability (GCA) is an important mission of cognitive neuroscience. Recent large-sample cohort studies measured GCA through multiple cognitive tasks and explored its neural basis, but they did not investigate how task number, factor models, and neural data type affect the estimation of GCA and its neural correlates. To address these issues, we tested 1,605 Chinese young adults with 19 cognitive tasks and Raven's Advanced Progressive Matrices (RAPM) and collected resting state and n-back task fMRI data from a subsample of 683 individuals. Results showed that GCA could be reliably estimated by multiple tasks. Increasing task number enhances both reliability and validity of GCA estimates and reliably strengthens their correlations with brain data. The Spearman model and hierarchical bifactor model yield similar GCA estimates. The bifactor model has better model fit and stronger correlation with RAPM but explains less variance and shows weaker correlations with brain data than does the Spearman model. Notably, the n-back task-based functional connectivity patterns outperform resting-state fMRI in predicting GCA. These results suggest that GCA derived from a multitude of cognitive tasks serves as a valid measure of general intelligence and that its neural correlates could be better characterized by task fMRI than resting-state fMRI data.

Developing patient safety scale for hospitals

Background/aim

The study aimed to contribute to the literature with a reliable and valid scale for hospitals to be used in determining the current patient safety culture and following up on its development.

Materials and methods

The study was conducted with the participation of 1137 healthcare professionals selected using the convenience sampling method in 3 secondary-care state hospitals and three research and training hospitals, one of which was affiliated with a medical faculty, and two were affiliated with the Health Sciences University. To begin with, to discover the latent structure of the items on the scale, an Exploratory Factor Analysis (EFA) was performed. Additionally, to determine the factor structure of the scale, the Confirmatory Factor Analysis (CFA) method was used. The Cronbach's alpha coefficient was calculated to check the reliability of the responses.

Results

According to Kaiser-Meyer-Olkin (KMO = 0.924) coefficient and the result of Bartlett's test of sphericity (χ 2 = 9748.777, df = 770), it was determined that the data structure was suitable for factor analysis. The Cronbach's alpha coefficient of the total scale was found to be 0.921. According to the EFA results, the scale was determined to have seven subscales, which were 1. Organizational Learning, Development, and Communication, 2. Management Support and Leadership, 3. Reporting Patient Safety Events, 4. Number of Personnel and Working Hours, 5. Response to Error, 6. Teamwork, and 7. Working Environment. The goodness-of-fit index results of the scale showed a good model fit (χ 2 / df = 3.04, RMSEA = 0.06, CFI = 0.97, NFI = 0.95, IFI = 0.97, SRMR = 0.06). The Cronbach's alpha coefficients of the subscales varied between 0.66 and 0.91.

Conclusion

The results showed that the Patient Safety Scale for Hospitals is a valid and reliable measurement instrument for healthcare professionals.

Validity and Reliability of the Turkish version of the Affiliated Stigma Scalefor Caregivers of Dementia

OBJECTIVE

The aim of this study was to adapt the "Affiliated Stigma Scale" to Turkish for caregivers of people with dementia and determine its psychometric properties. The scale measures the affiliated stigma experienced by caregivers of people with dementia.

METHOD

We assessed the psychometric properties of Affiliated Stigma Scale in 218 adults who were primary caregivers for their relatives with dementia. Sociodemographic data was collected and the Affiliated Stigma Scale, the Caregiver Burden Inventory, and the Beck Depression Inventory were administered.

RESULTS

The Confirmatory Factor Analysis results did not support the three-factor structure of the original scale, Exploratory Factor Analysis (EFA) was performed. EFA, revealed that the Turkish form of the Affiliated Stigma Scale has a four-factor structure as "other related/ cognition", "emotion", "self-related", and "behavior" with a total of 20 items. The variance explained by four factors constitutes 65.34% of the total variance. It was positively correlated with depression and caregiver burden scores. The internal consistency coefficients of the scale range was between 0.82 and 0.86 and was 0.91 for the total scale.

CONCLUSION

The Affiliated Stigma Scale is a valid and reliable measurement tool in Turkey for the caregivers of people with dementia in assessing affiliated stigma.

The catcher in the mind: validation of the brief-mentalized affectivity scale for adolescents in the Italian population

The concept of mentalized affectivity (MA) encompasses the dimensions of identifying, processing, and expressing emotions and describes the process of making sense of and reevaluating one's affects in light of autobiographical memory. This construct was developed within the theoretical framework of mentalization and, due to its interpersonal nature, added further complexity to the emotion regulation construct. This research aimed to examine the factor structure and psychometric properties of the Brief-Mentalized Affectivity Scale for adolescents (B-MAS-A) on an Italian sample of young people (aged 13-19 years). Data were collected using non-probabilistic sampling and an online survey. Participants were asked to complete a large battery of instruments, including the B-MAS-A, the Toronto Alexithymia Scale, the Reflective Functioning Questionnaire, the Epistemic Trust, Mistrust, and Credulity Questionnaire, the Strengths and Difficulties Questionnaire, and the General Self-Efficacy Scale. In study 1, factor analyses carried out on a total sample of 566 adolescents identified 3 distinct dimensions of the same components of MA found in the adult population: i) identifying; ii) processing; iii) expressing emotions. The subscales showed excellent internal consistency. Study 2 (involving a subsample of 288 participants) demonstrated good levels of construct and criterion validity. These results confirm that the B-MAS-A represents a valid and robust instrument for assessing the complex and multifaceted characteristics of MA in adolescents. The B-MAS-A can make a significant contribution to clinical practice and research and encourage systematic studies on MA in psychotherapy, taking into account the developmental stage of adolescence.

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.

Symptom clustering of major depression in a national telehealth sample

BACKGROUND

Major depressive disorder (MDD) is a heterogeneous disorder whose possible symptom combinations have not been well delineated. The aim of this study was to explore the heterogeneity of symptoms experienced by those with MDD to characterize phenotypic presentations.

METHODS

Cross-sectional data (N = 10,158) from a large telemental health platform were used to identify subtypes of MDD. Symptom data, gathered from both clinically-validated surveys and intake questions, were analyzed via polychoric correlations, principal component analysis, and cluster analysis.

RESULTS

Principal components analysis (PCA) of baseline symptom data revealed 5 components, including anxious distress, core emotional, agitation/irritability, insomnia, and anergic/apathy components. PCA-based cluster analysis resulted in four MDD phenotypes, the largest of which was characterized by a prominent elevation on the anergic/apathy component, but also core emotional. The four clusters differed on demographic and clinical characteristics.

LIMITATIONS

The primary limitation of this study is that the phenotypes uncovered are limited by the questions asked. These phenotypes will need to be cross validated with other samples, potentially expanded to include biological/genetic variables, and followed longitudinally.

CONCLUSIONS

The heterogeneity in MDD, as illustrated by the phenotypes in this sample, may explain the heterogeneity of treatment response in large-scale treatment trials. These phenotypes can be used to study varying rates of recovery following treatment and to develop clinical decision support tools and artificial intelligence algorithms. Strengths of this study include its size, breadth of included symptoms, and novel use of a telehealth platform.

New cut-off points of PHQ-9 and its variants, in Costa Rica: a nationwide observational study

The PHQ-9 questionnaire is a screening test worldwide used to measure depression. But it cannot be used in Costa Rica, due to the fact that it has not previously been validated for its population. The present study aims to show the validation of the PHQ-9 questionnaire and its variants (PHQ-2, PHQ-4, PHQ-8) in a population sample of adults residing in Costa Rica. A sample was collected (n = 1162) using a self-administered questionnaire. Confirmatory Factor Analysis (CFA), Receiver Operating Characteristic (ROC) curve, and Multiple Group Confirmatory Factor Analysis (MGCFA) were tested. One factor was found that explained 73.33% of the variance with excellent internal consistency (α = 0.928). Goodness-of-fit measures were adequate (RMSEA = 0.107; CFI = 0.948), as was diagnostic power at a cut-off of 10 (78.60 for Sensitivity and 27.95 for 1-Specificity). External validation indices were good (r = 0.843 with GAD-7, r = - 0.647 with RS14, and r = 0.301 with FCV19S), and the model showed invariance by sex (∆χ2 = 27.90; df = 27; p < 0.001). Additionally, new cut-off points were proposed for PHQ-9 and its variants for Costa Rican male, female, and general populations. The PHQ-9 and its variants (PHQ-2, 4, and 8) are valid tools for detecting depression (and anxiety for PHQ-4) in Costa Rican population. In addition, new cut-off points differentiated by sex are proposed.

Gulliksen's pool: A quick tool for preliminary detection of problematic items in item factor analysis

Exploratory factor analysis is widely used for item analysis in the earlier stages of scale development, usually with large pools of items. In this scenario, the presence of inappropriate or ineffective items can hamper the process of analysis, making it very difficult to correctly assess dimensionality and structure. To minimize, this (quite frequent) problem, we propose and implement a simple procedure designed to flag potentially problematic items before we specify any particular factorial solution. The procedure defines regions of item appropriateness and efficiency based on the combined impact of two prior item features: extremeness and consistency. The general proposal is related to the most widely used frameworks for item analysis. The limits of the appropriateness regions are obtained by extensive simulation in conditions that mimic those found in applications. An Item Response Theory index of prior item efficiency is then defined, and a combined approach for selecting the most effective and problem-free item sub-set is proposed. The proposal is useful to normal-range measures, such as questionnaire surveys that elicit reports about non-extreme attitudes, facts, beliefs or states, or personality questionnaires that measure normal-range constructs. The procedure is implemented in a freeware software.

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.

Psychometric properties of Fagerström Tolerance Questionnaire among Turkmen Nass (Naswar) users

BACKGROUND

Smokeless tobacco (SLT) products are gaining popularity around the globe, particularly in Asia, Africa, and the Middle East. Among these products, Nass (aka Naswar) is popular among the Turkmen ethnicity in Iran. Although several studies reported nicotine dependence (ND) among SLT users, psychometric instruments have never been utilized to specifically measure ND among Nass users. Therefore, in this study, we aimed to evaluate the reliability and validity of the Fagerström Tolerance Questionnaire (FTQ) among Turkmen Nass users.

METHODS

A cross-sectional, descriptive study was conducted in June-December 2018 among 411 Turkmen adults who currently (past 30 days) used Nass. Two bilinguals (Persian English) individuals translated and back-translated the FTQ-SLT, which maintained both the questionnaire's accuracy and cultural sensitivity. Construct validity was assessed using exploratory and confirmatory factor analysis.

RESULTS

The mean age and standard deviation for initiating Nass were 22.5 ± 11.81 years. Exploratory and confirmatory factor analysis indicated a single-factor solution with 8-items that captured several important ND components. Using Nass frequently, soon after waking, when sick, and experiencing a craving were some of the main components. Subgroups comparison revealed that higher scores occurred among those who were married, had Nass user(s) in their immediate family, and consumed bulk form of Turkmen Nass directly without using a tissue.

CONCLUSION

Our findings show that the FTQ- SLT is a fairly reliable and valid scale to measure ND among Turkmen Nass users and warrants further testing to accommodate cross-cultural differences in other populations.

Dual career competency questionnaire for athletes: psychometric properties of the Brazilian version

Introduction

No studies have yet attempted to quantitatively measure the competencies of Brazilian student-athletes. Consequently, there are no validated measures suitable for this purpose. The aim of this research was to examine the psychometric properties and assess content validity, factorial validity and evidence based on response processes of the Brazilian version of the Dual Career Competency Questionnaire for Athletes (DCCQ-A).

Methods

The Brazilian DCCQ-A was administered to 745 student-athletes (M_age = 17.3 ± 5.4; 54% female; 8% student-athletes with disabilities).

Results

Content validity coefficient analysis indicated clarity of language, theoretical pertinence, and practical relevance of the Brazilian DCCQ-A items. Confirmatory factorial analysis revealed excellent goodness-of-fit indices of the 4-factor structure model. Polytomous Rasch analysis demonstrated an acceptable adjustment of the items and good organization in the item response categories.

Discussion

Considering the psychometric strength of the Brazilian DCCQ-A, this instrument can contribute to the practical and research applicability of sport psychology, providing support to those involved with student-athletes' dual career by identifying their competencies and possible limitations.

Knowledge, attitudes, behavioral and organizational factors of health professions students for a competent smoking cessation practice: An instrument adaptation and psychometric validation study in Spanish and English samples

BACKGROUND

To improve smoking cessation, training of health professions students is essential. However, no specific instrument is available to assess factors that may affect students' learning about smoking cessation practice.

AIM

To adapt and validate the Knowledge, Attitudes, Behaviors and Organization questionnaire in the population of undergraduate health professions students.

DESIGN

Methodological research.

METHODS

The researchers conducted this study with 511 Spanish and 186 English health professions students from four different universities. We used a four-step approach: 1) adaptation of the items to the target population and validation of the content by a panel of experts; 2) a pilot study to test face validity; 3) linguistic adaptation of the Spanish version to English; and 4) the psychometric assessment based on construct validity, criterion validity and internal consistency.

RESULTS

Exploratory factor analysis revealed four subscales for the Spanish version, namely 'Individual knowledge and skills', 'Individual attitudes and beliefs', 'Organizational support' and 'Organizational resources', which accounted for 85.1% of the variance. Confirmatory factor analysis in the holdout Spanish and English samples revealed adequate goodness-of-fit values, supporting the factor structure. Hypotheses testing demonstrated significant differences by capacitation in smoking cessation interventions and degree courses, providing further evidence regarding construct validity. All the subscales correlated positively with the criterion variables (5 A's smoking cessation model), except for the 'Organizational resources' subscale, which was not significantly correlated with the 5 A's. The overall Cronbach's alpha was.83 for the Spanish version and.88 for the English one.

CONCLUSIONS

Our results provide empirical support for the use of the Knowledge, Attitudes, Behaviors and Organization questionnaire for Students as a reliable and valid instrument to assess knowledge, attitudes, behaviors and organization perceptions in health professions students, which is essential for competent smoking cessation practice. Interestingly, 'Organizational resources' subscale presented the lowest correlations among factors and did not correlate with any component of the 5 A's, suggesting the need of enhancing students' responsibility and involvement during their internships, as well as the interest of some organizations.

Validation of a Questionnaire to Analyze Teacher Training in Inclusive Education in the Area of Physical Education: The CEFI-R Questionnaire

Inclusive education is a right that has captured the attention of public institutions, researchers, and teaching professionals around the world. The beliefs and perceptions of teachers are a fundamental axis in knowing the state of these professionals regarding this ethical principle, allowing them to develop and implement different strategies. This study aims to explore the reliability and factor structure of the Evaluation of Teachers' Preparation for Inclusion (CEFI-R) questionnaire among physical education teachers. The sample consisted of 789 Spanish in-service teachers who completed the questionnaire to assess their readiness for inclusion in this subject. Exploratory and confirmatory factor analyses as well as reliability testing were carried out. A factor structure with four dimensions (conception of diversity, methodology, support, and community participation) was obtained. These dimensions consisted of 17 items with good and excellent goodness-of-fit values. In addition, a high reliability was obtained (Cronbach's Alpha = 0.71-0.93). Therefore, the CEFI-R could be considered a valid and reliable tool to analyze physical education teachers' perceptions of their preparedness for inclusive education.

Reliability and validity study of the Thai adaptation of the Maslach Burnout Inventory-Student Survey among preclinical medical students at a medical school in Thailand

Burnout syndrome is characterized by emotional exhaustion, cynicism, and lack of professional efficacy. A considerable proportion of medical students experience burnout syndrome during their educational training. Therefore, this issue has become a major concern in the medical education community. The Maslach Burnout Inventory-Student Survey (MBI-SS) is the most widely used assessment of burnout syndrome among college students, including preclinical medical students. Therefore, our objective was to culturally modify and validate the MBI-SS in a Thai context for use with preclinical medical students. The MBI-SS comprises 16 items, including five items for emotional exhaustion, five items for cynicism, and six items for academic efficacy. Four hundred and twenty-six preclinical medical students participated in this study. We randomly divided the samples into two equivalent subsamples of 213 participants. The first subsample was used to calculate McDonald's omega coefficients to assess internal consistency and to perform exploratory factor analysis. McDonald's omega coefficients for exhaustion, cynicism, and academic efficacy were 0.877, 0.844, and 0.846, respectively. The scree plot from the unweighted least squares estimation and a direct oblimin rotation, supplemented with Horn's parallel analysis and the Hull method, revealed three major factors of the Thai MBI-SS. Due to the violation of the multivariate normality assumption in the second subsample, we performed a confirmatory factor analysis with the unweighted least squares with a mean and variance adjusted estimation approach. The results of the confirmatory factor analysis showed favorable goodness-of-fit indices. Data from 187 out of 426 participants (43.9%), who completed a second questionnaire, were utilized to evaluate test-retest reliability. The correlation coefficients for test-retest reliability with a three-week period between tests were 0.724, 0.760, and 0.769 for the exhaustion, cynicism, and academic efficacy domains, respectively (all p < 0.05). This indicates that the Thai MBI-SS is a valid and reliable instrument to assess burnout syndrome in our Thai preclinical medical student population.

Structure internal of the dimension Human Person of the Questionnaire of Health Vulnerability in Heart Failure

OBJECTIVE

to analyze the evidence of validity of the internal structure of the dimension Human Person of the Questionnaire of Health Vulnerability in Heart Failure.

METHOD

psychometric study with 1,008 people with heart failure, in a tertiary healthcare institution located in Northeastern Brazil. The internal structure was assessed by exploratory factor analysis with a polychoric correlation matrix, followed by confirmatory factor analysis to verify the quality of the model fit. Internal consistency was measured by composite reliability (CR) and McDonald's omega (ω).

RESULTS

psychometric parameters revealed 22-item model, distributed in five factors, total explained variance of 64.9%, factor loadings (0.38 to 0.97) and adequate communalities (0.20 ≤ h2 ≤ 0.98) and acceptable indicators of precision (0.79 ≤ ORION ≤ 0.98), representativeness (0.89 ≤ FDI ≤ 0.99), sensitivity (1.92 ≤ SR ≤ 7.07), factor expectancy (88.3% ≤ EPTD ≤ 97.9%), replicability (0.82 ≤ H-latent ≤ 0.97; 0.81 ≤ H-observed ≤ 0.87) and reliability (CR = 0.92 and ω = 0.83). Adequate adjustment quality was achieved (TLI = 0.99; CFI = 0.99; GFI = 0.99; RMSEA = 0.04 and RMSR = 0.04).

CONCLUSION

We obtained an instrument with good evidence of internal structure validity for construct measurement.

Bullying and Emotional Problems in Pupils from 11 to 13 Years Old: Joint Detection through Self-Report

The objective of this study was to adapt and make available a valid instrument based on a joint questionnaire (self-report type) to detect the risk of bullying and emotional problems in pupils aged from 11 to 13 years. The questionnaires used were that of Spain's Ombudsman (Defensor del Pueblo) to detect the risk of becoming a victim of bullying and an adaptation of Spain's CECAD to assess the risk of emotional problems. The participants were 1077 gender-matched subjects enrolled in the 6th year of Primary Education (n = 467) and the 1st year of Lower Secondary Education (n = 610) from 19 schools in the Region of Extremadura. High reliability was obtained in both questionnaires, as well as a significant relationship between bullying and emotional problems (0.36). The scales place the pupils at either a certain risk level (mild, moderate, or severe) or no risk. The study concludes with the description of four situations deriving from the cross relationship between victimization and the pupil's emotional problems: (1) no risk of bullying and no risk of emotional problems (73.2%), (2) risk of bullying but no risk of emotional problems (11.1%), (3) no risk of bullying but risk of emotional problems (9.4%), and (4) risk of bullying and risk of emotional problems (6.3%).

Validity and Psychometric Properties of the ILO-WHO Workplace Stress Scale: A Study with Workers from the Canary Islands

Occupational stress, as a negative facet, is a pervasive problem with significant implications for organizations, employees, welfare systems and health. The implementation of measurement tools that can capture the different organizational dimensions that determine stress in workers is part of the stress management and troubleshooting strategy that every company must manage daily. The aim of the present study was to adapt and validate the 25-item version of the ILO-WHO stress scale by Ivancevich and Matteson in the context of the Canary Islands of Spain. The tool assesses specific organizational dimensions of work-related stress determinants: organizational climate and structure, leader influence, cohesion, territory, technology and group support. An exploratory factor analysis (EFA) on a sample of 1510 Canary Islands workers was carried out. The results indicate that the job stress scale revealed adequate psychometric properties, construct validity and internal consistency (Cronbach's alpha = 0.972), and it can be profitably used to measure stress. At the end of the paper, theoretical and practical implications are discussed.