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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Consensus on the content of an instrument to measure person-centred teamwork: An e-Delphi study

AIMS AND OBJECTIVES

To establish consensus on items to be included in an instrument to measure person-centred teamwork in a hospital setting. The objective was to identify the items through a methodological literature review. Refine the items and obtain consensus on the items.

BACKGROUND

A definition and related attributes of person-centred teamwork have been agreed upon. An instrument is needed to measure and monitor person-centred teamwork in hospital settings.

DESIGN

Consensus, electronic Delphi design.

METHODS

Items were identified through a methodological literature review. These items were included in three electronic Delphi rounds. Using purposive and snowball sampling, 16 international experts on person-centred care, teamwork and/or instrument development were invited to participate in three electronic Delphi rounds via Google Forms. Descriptive statistics were used to demonstrate their agreement on the relevance and clarity of each item. Items were included if consensus was 0.75. Content analysis was used to analyse written feedback from experts.

RESULTS

The response rate was 56% (n = 9/16). Nine experts participated over an 8-week period to reach consensus on the items to be included in an instrument to measure person-centred teamwork in hospital settings. The experts' responses and suggestions for rephrasing, removing and adding items were incorporated into each round.

CONCLUSION

A Delphi consensus exercise was completed, and experts reached agreement on 38 items to be included in an instrument that can be used to evaluate person-centred teamwork in hospital settings.

RELEVANCE TO CLINICAL PRACTICE

We engaged with nine international experts in the academic and clinical field of person-centeredness, teamwork and/or instrument development. An online platform was used to allow the experts to give input into the study. The experts engaged from their own environment with full autonomy and anonymity. Person-centred teamwork, aimed at improving practice is now measurable. Person-centred teams improve outcomes of patients. Person-centred teamwork was specifically developed to assist low compliance areas in hospitals.

Development and psychometric testing of physiopsychological disorders scale for medical rescuers fighting epidemics in China

OBJECTIVE

Develop and psychometrically test the physiopsychological disorders scale for medical rescuers fighting epidemics (PDS-MRFE).

METHOD

A three-phase approach was used to develop and test the physiopsychological disorders scale: (1) creating the item pool, (2) preliminarily evaluating items, and (3) refining the scale and estimating the psychometric properties. The items of the instrument were generated based on a comprehensive literature review and a qualitative study conducted with 31 medical rescuers (18 nurses and 13 doctors) fighting epidemics. A preliminary evaluation of items was conducted using content validity which was evaluated by a panel of 15 experts. Validity and reliability examinations were conducted to refine the scale and evaluate its psychometric properties. This was done using two different samples. Specifically, Sample A (360 medical rescuers) was employed for item reduction and exploratory factor analysis (EFA), and Sample B (287 medical rescuers) was employed for the confirmatory factor analysis (CFA) and determination of other psychometric properties (i.e., reliability, concurrent, convergent, and discriminant validity), which further confirmed the structure of the scale and evaluated its final psychometric properties.

RESULTS

The final scale has 39 items with three subscales, including before, during, and after rescue. The exploratory factor analysis result indicated that the before-rescue scale of four items, during-rescue of 21 items, and after-rescue of 14 items explained 52.07%, 69.75%, and 52.30% of the cumulative variance, respectively. The confirmatory factor analysis result indicated that model fit indices of three subscales were acceptable and showed evidence of adequate content, convergent, discriminate, and concurrent validity. The Cronbach's α coefficients for each subscale and all dimensions ranged from 0.81 to 0.92, indicating good reliability for the PDS-MRFE.

CONCLUSIONS

The physiopsychological disorders scale is a psychometrically valid and reliable instrument and can be used in both clinical practice and research to evaluate different physiopsychological disorders at different medical rescue stages among medical rescuers fighting epidemics.

The Neurodiversity Attitudes Questionnaire: Development and Initial Validation

LAY ABSTRACT

Neurodiversity refers to the idea that brain differences (including disabilities) are valuable and should be accepted. Attitudes toward neurodiversity can have real-life impacts on the lives of neurodivergent people (those whose brains do not fit society's "standard"). These impacts can include effects on daily interactions, as well as how professionals such as teachers and doctors deliver services to neurodivergent people. In order to identify negative attitudes toward neurodiversity and potentially improve them, we first need to measure these attitudes. This article describes the development of the Neurodiversity Attitudes Questionnaire (NDAQ). NDAQ development included revision of questionnaire items based on feedback from experts and neurodivergent people, systematically evaluating the way participants responded to questionnaire items, and analysis of how the NDAQ items are grouped into different factors. A preliminary analysis with 351 individuals mostly living in the United States who were currently working or planning to work in a helping profession (e.g. doctors, teachers, therapists, and so on) indicates that the NDAQ measures attitudes toward neurodiversity, is well understood by participants, and fits a five-factor structure. While the NDAQ represents the first instrument designed to specifically assess attitudes toward the broad idea of neurodiversity, further work is still needed.

Development and validation of a delirium care critical-thinking scale for intensive care unit nurses: A mixed-method study

AIM AND OBJECTIVES

To develop a Delirium Care Critical-Thinking Scale for nurses caring for patients in the intensive care unit and examine the scale's psychometric properties.

BACKGROUND

There is a tool to evaluate nurses' critical thinking skills to determine nursing competency when delirium care is required.

DESIGN

This cross-sectional, mixed-methods study.

METHODS

The Delphi method was applied for collection and analysis of data during conceptualization and item generation of the tool (Phase I). Item analysis, assessment of validity and reliability of the scale (Phase II) involved 318 nurses recruited by convenience sampling from nine adult intensive care units in medicine and surgery at one medical centre. Confirmatory factor analysis assessed construct validity. Internal consistency and 2-week test-retest stability measured reliability. A Critical Thinking Disposition Inventory Scale examined concurrent validity.

RESULTS

After three rounds, the Delphi method resulted in 31 scale items. Item analysis demonstrated construct reliability ranged from 9.23 to 16.18. Confirmatory factor analysis eliminated one item and extracted five factors: applying knowledge, confirming the problem and accuracy of information, reasoning logically, choosing appropriate strategies and remaining open-minded. Average variance extracted values of all factors indicated good convergent validity. Cronbach's α for internal consistency was .96 with good test-retest reliability. The correlation coefficient for concurrent validity was .301.

CONCLUSION

The new Delirium Care Critical-Thinking Scale for intensive care nurses was demonstrated to be a reliable and valid tool for evaluating their ability to assess patients with delirium.

RELEVANCE TO CLINICAL PRACTICE

This new scale could be used to assess outcomes of education interventions and the effectiveness of nursing care quality involving patients with delirium in intensive and critical care units.

REPORTING METHOD

The COSMIN checklist was used as the reporting guideline for this study.

PATIENT OR PUBLIC CONTRIBUTION

None.

Development and Validation of a Patient Discharge Readiness Scale for Daytime Cataract Surgery (DRS-CAT)

PURPOSE

To ensure the safety of patients discharged from the hospital, a nurse-assessed scale for outpatient cataract surgery patients was constructed to provide a special tool for cataract patients' discharge readiness evaluation.

DESIGN

This is a methodological study.

METHODS

The development of the tool was completed between 2021 and 2022. Based on the literature review and qualitative interviews, the initial entry pool of the discharge readiness scale was established. After consultation with Delphi experts, the preliminary scale was tested by 312 participants to screen items and test reliability and validity. The analysis included internal consistency, content validity, and construct validity. The Strengthening the Reporting of Observation studies in Epidemiology (STROBE) checklist was used as the reporting guideline for this study.

FINDINGS

The final Discharge Readiness Scale for Cataract surgery consists of 21 items in five dimensions: cognition of discharge readiness, personal status, mastery of health education knowledge, coping capacity, and social support. Five common factors were extracted from the exploratory factor analysis, and they explained 70.12% of the total variance. All of the indexes of the confirmatory factor analysis were within the theoretical allowable range. The Cronbach's α of the total scale was 0.903, and the scale-level content validity index/average variance extracted was 0.99.

CONCLUSIONS

The Discharge Readiness Scale for Cataract surgery, evaluated by nurses, has good reliability and validity and can be used to determine the discharge readiness of cataract patients undergoing day surgery.

Development and Validation Process of the Intensive Care Unit Omitted Nursing Care (ICU-ONC) Instrument Among French Canadian Nurses

Background and Purpose: The purpose of this article is to document the development and validation process of an instrument adapted for French-speaking nurses and to measure the occurrence of omitted nursing care (ONC) in the intensive care unit (ICU). Methods: An electronic Delphi panel, involving ICU nursing experts from the province of Quebec (Canada), was used to develop the intensive care unit omitted nursing care (ICU-ONC) instrument. For the validation process, an electronic cross-sectional survey was conducted. Results: A total of 564 nurses participated in the validation study. Exploratory factor analysis performed on 478 complete observations supports the presence of a single-factor structure for the 22-item ICU-ONC instrument. Coefficient alpha for the scale was .93, 95% confidence interval (CI) was [0.92, 0.94], item-partial total correlations ranged from .49 and .68, and the mean/median interitem correlations were .38 and .37, respectively. Moderate negative correlations were found between the ICU-ONC instrument overall score and two related constructs: nurses' perception of the quality as well as the safety of care. Conclusions: Our current understanding of ONC in the ICU is based on the results drawn from the administration of generic instruments to ICU nurses. The novel 22-item ICU-ONC instrument can help better estimate the occurrence of the phenomena in the ICU.

Content Validity of Assessment Instrument for High-Performance Work Systems in Health Care Industry

Background and Purpose: The main purpose of this article is to content validate and evaluate a measuring instrument of high-performance work systems (HPWS) in healthcare organizations that capture the nurses' perception of HPWS present in their working organization. Methods: A panel of six experts participated to validate the HPWS instrument through their feedback. Later, coding and recoding of expert feedback were performed to calculate the item content validity index (I-CVI), scale content validity index (S-CVI), and Kappa statistic coefficient (K*) to rate its content validity. Results: For 50 out of 52 items of the measuring instrument, I-CVI is well above the recommended minimum acceptable value of .78. The S-CVI value is observed as .94, and the K* value is above .74 for 50 items. Conclusion: The results indicated excellent content validity for all the domains indicating evidence that the HPWS scale and the items on it are content valid and can be used for nursing research in the healthcare industry.

Validity and Reliability Evidence of the Munro Scale for Perioperative Patients, Part I: Correlation, Multiple Regression, and Reliability

Background and Purpose: Patients undergoing surgery are at risk of pressure injury development and should be assessed to ensure measures are taken for prevention. The study's purpose was to examine the causal relationships and reliability of the Munro Pressure Injury Risk Assessment Scale for Perioperative Patients (Munro Scale). The Munro Scale is the first dynamic risk scale available for this patient population in the acute clinical setting. Methods: This study was a retrospective review to explore the relationships of the variables in the Munro Scale, identify the strongest predictors, and measure the reliability of previously collected data from two northeastern community hospitals. A total of 630 risk assessments were analyzed to obtain regression, correlation, and reliability evidence for the Munro Scale. Results: The correlation analysis among the 15 risk variables and combined comorbidities revealed commonalities among the variables and significant relationships to the final postoperative injury score. The model as a whole is significant to predict the final level of risk. Coefficient alpha revealed a lower than anticipated reliability when compared to the Chinese, Turkish, and Brazilian versions of the Munro Scale. Conclusions: There are significant relationships among the variables, and the scale is acceptable for use in the acute perioperative practice setting. This study has both clinical and statistical significance.

Patient perspectives of quality of life in chronic limb-threatening ischemia: a qualitative study

BACKGROUND

Quality of life (QOL) is an outcome that matters to patients with chronic limb-threatening ischemia (CLTI). However, we identified the lack of and need for a CLTI-specific QOL instrument. Our group is developing this instrument which requires a deep understanding of patient perspectives of QOL in CLTI.

METHODS

Qualitative inquiry with patient and public involvement was performed in accordance with the Standards for Reporting Qualitative Research. Reflexive thematic analysis of semi-structured interviews was conducted within a constructivist-interpretivist research paradigm. Data were organized and managed in NVivo. Techniques to enhance trustworthiness included maintaining an audit trail, member checking, mentoring, and peer-debriefing. Patient and the public were consulted for feedback on codes, themes, and thematic maps.

RESULTS

Thirteen participants (median age: 74 years, range: 43-90 years) with a variety of patient demographics were interviewed. Four themes were developed on QOL in CLTI: (i) 'independence as key to life satisfaction', (ii) 'change in identity when continuity is needed', (iii) 'coping with intractable disease', and (iv) 'not wanting to be alone'. Member checking with patient and public involvement confirmed the relevance and centrality of these themes to the lived experiences of patients with CLTI.

CONCLUSIONS

The thematic outputs contribute important insights into what QOL truly means to patients with CLTI and what matters for their QOL. The content validity of the new CLTI-specific QOL instrument is improved by giving patients voice. This study highlights the value of qualitative inquiry and patient and public involvement in vascular surgical research.

Development and Psychometric Test of the Salutogenic Survey on Sustainable Working Life for Nurses: Identifying Resistance Resources against Stress

Extensive research shows nurses' work environment to be particularly stressful. This study develops, explores, and psychometrically tests a new profession-specific questionnaire identifying generalised and specific resistance resources, that make it possible to measure resources to manage work-related stress. An exploratory study design was employed. The questionnaire development was inspired by the MEASURE approach and the salutogenic theory of health. Building on the results from a literature review of nursing research and salutogenesis, supplemented by twelve interviews with hospital nurses, an item pool was generated. The first version was pilot-tested in a group of nurses who were studying to become specialist nurses. The second version of the questionnaire was psychometrically tested on a sample of registered nurses in close patient care (n = 475), analysed using confirmatory factor analysis to test seven predefined domains of the questionnaire. The analysis revealed a first order seven-domain model of 21 items: job satisfaction, professional role, work motivation, commitment, belonging in the workplace, factors and conditions for remaining in the profession, and workload. The structure of the questionnaire indicates its usefulness in clinical practice for measuring resistance resources.

Attitudes towards vaccination among parents of children aged 0-5 years: A scale development study

BACKGROUND

Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children.

DESIGN

This study was designed as an instrument development study.

METHODS

This study aimed to develop a scale to measure the attitudes of parents with children aged 0-5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item-level test-retest analyses for reliability.

RESULTS

The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28-item two factors = 62.47%).

CONCLUSION

This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health-care services based on the results of the measurement.

Development and Validation of a Breastfeeding Health Literacy Scale (BFHLS) for Taiwanese Pregnant Women

BACKGROUND

Breastfeeding is the best source of nutrition for infants. Health literacy is a critical factor affecting breastfeeding rates.

RESEARCH AIMS

The aim of this research was to develop and test the Breastfeeding Health Literacy Scale to determine its validity and reliability.

METHODS

This study featured a cross-sectional telephone survey design. Researchers reviewed the literature and used expert opinions to develop the content-validated 30-item Breastfeeding Health Literacy Scale covering five dimensions. We examined internal consistency, exploratory factor analysis, and confirmatory factor analysis to assess reliability and construct validity. A Taiwanese government organization provided potential participants' contact information. After mailing an invitation letter, researchers phoned all participants to invite participation, obtain oral consent and complete a Breastfeeding Health Literacy Scale and collect demographic data.

RESULTS

Participants (N = 300) had a mean age of 31.8 (SD = 4.66) years. The item-level content validity index was 0.67 to 1.00 and scale-content validity index was 0.94. After performing exploratory factor analysis, three factors were extracted. Examining content factor analysis for the three factors resulted in χ2/df = 2.05; p < .001; goodness of fit index = 0.90; Comparative Fit Index (CFI) = 0.96; and Root Mean Square Error of Approximation (RMSEA) = 0.06. Cronbach's alphas on the total scale and the subscales ranged from 0.87 to 0.94. Women with multigravida, breastfeeding information from physicians and nurses, and previous breastfeeding experience had better breastfeeding health literacy.

CONCLUSIONS

Psychometric analysis demonstrated that the newly developed 20-item Breastfeeding Health Literacy Scale is a valid self-assessment instrument. Improving breastfeeding health literacy during pregnancy could help enable breastfeeding success.

A novel approach to understanding and assessing the emotional side of type 1 diabetes: The Type 1-Diabetes Distress Assessment System

AIMS

To describe the development of a novel, conceptually sound instrument with contemporary content for assessing diabetes distress (DD) among adults with type 1 diabetes.

METHODS

Qualitative interviews with 15 adults and 7 clinicians were used to develop Core (intensity of DD emotional burden) and primary Source (key DD contributors) items. These were administered to a national sample recruited from the TCOYD Research Registry, T1D Exchange and our previous studies. Exploratory and confirmatory factor analyses were undertaken, along with reliability and construct validity studies, and cut-point analyses to determine elevated DD.

RESULTS

Analyses based on 650 respondents yielded an 8-item Core DD scale (α = 0.95) and 10 2- or 3-item DD Source Scales (α range = 0.53-0.88): Financial Worries, Interpersonal Challenges, Management Difficulties, Shame, Hypoglycemia Concerns, Healthcare Quality, Lack of Diabetes Resources, Technology Challenges, Burden to Others and Worries about Complications. Core and Source scores were significantly associated with criterion variables: Higher DD scores were significantly linked with higher HbA1C , more frequent episodes of severe hypoglycaemia, missed boluses, and poorer quality of life (p > 0.001). A ≥2.0 scale cut-point to define elevated DD is suggested.

CONCLUSIONS

The new T1-Diabetes Distress Assessment System demonstrated good reliability and validity, and with measures of both Core emotional burden and Sources of DD, it provides a contemporary, flexible and practical approach to assessing DD that can be used seamlessly to inform intervention for clinicians and researchers.

Adaptation of the SAGEFS scale on attitudes toward gender equality in football in the international school context

The objective of the present study is to evaluate the psychometric properties of the Scale of Attitudes toward Gender Equality in Football in the Context of Schools (SAGEFS) in the international context. This sample was formed by N = 6,101 students. The study was conducted by applying the SAGEFS. The model of the three factors correlated in the complete sample and for each country was correlated using AFC. The structural model was appraised by employing eight indices: the relative Chi-squared index; the goodness of fit index and its adjusted formula; the normal fit index; the comparative fit index; the standardized Quadratic Mean; and the Quadratic Mean Error of Approximation. To conclude, the results evidence the presence of psychometric properties that are indispensable for the measurement of attitudes toward gender equality in the context of schools.

Validation of the Health Protective Sexual Communication Scale Among Young Adults in the United Kingdom and Spain

Background and Purpose: The transmission of sexual infections is increasing globally. The research aims to validate the Health Protective Sexual Communication Scale (HPSC) in English and Spanish. Methods: The study survey was administered to 1,223 university students from Spain (658) and the United Kingdom (565) during the academic year 2020-2021. Results: Cronbach's alpha values were .80 (Spain) and .86 (United Kingdom). The scale's Exploratory and Confirmatory Factor Analysis displays a one-dimensional structure of eight items in both countries. Conclusions: The HPSC has excellent reliability and validity. Psychometric findings support the use of the HPSC as a screening tool to measure sexual risk in youth.

Are remote health clinics primary health care focused? Validation of the Primary Health Care Engagement (PHCE) Scale for the Australian remote primary health care setting

AIM

To test and validate a measure of primary health care (PHC) engagement in the Australian remote health context.

BACKGROUND

PHC principles include quality improvement, community participation and orientation of health care, patient-centred continuity of care, accessibility, and interdisciplinary collaboration. Measuring the alignment of services with the principles of PHC provides a method of evaluating the quality of care in community settings.

METHODS

A two-stage design of initial content and face validity evaluation by a panel of experts and then pilot-testing the instrument via survey methods was conducted. Twelve experts from clinical, education, management and research roles within the remote health setting evaluated each item in the original instrument. Panel members evaluated the representativeness and clarity of each item for face and content validity. Qualitative responses were also collected and included suggestions for changes to item wording. The modified tool was pilot-tested with 47 remote area nurses. Internal consistency reliability of the Australian Primary Health Care Engagement scale was evaluated using Cronbach's alpha. Construct validity of the Australian scale was evaluated using exploratory factor analysis and principal component analysis.

FINDINGS

Modifications to suit the Australian context were made to 8 of the 28 original items. This modified instrument was pilot-tested with 47 complete responses. Overall, the scale showed high internal consistency reliability. The subscale constructs 'Quality improvement', 'Accessibility-availability' and 'population orientation' showed low levels of internal consistency reliability. However, the mean inter-item correlation was 0.31, 0.26 and 0.31, respectively, which are in the recommended range of 0.15 to 0.50 and indicate that the items are correlated and are measuring the same construct. The Australian PHCE scale is recommended as a tool for the evaluation of health services. Further testing on a larger sample may provide clarity over some items which may be open to interpretation.

Operating room nurse's awareness and implementation status of the prevention of patient's intraoperative acquired pressure injuries: design and validation of a questionnaire

Aim

To compile the awareness and implementation status of patients with intraoperative acquired pressure injuries prevention by operating room nurses and to test its reliability and validity.

Design

This is an equipment development research based on recommendations for developing a reliable and valid questionnaire.

Methods

The research was carried out in two phases from February to November 2022. Through a panel discussion, expert consultation, and literature review, the questionnaire for operating room nurses on the current status of awareness and implementation of the prevention of intraoperative acquired pressure injuries was preliminarily formulated. The formal questionnaire was developed through validity analysis, reliability analysis and item analysis, and reliability and validity tests were conducted. Moreover, according to the questionnaire survey results, confirmatory factor analysis was carried out to construct the structural equation model.

Results

The initial questionnaire consisted of five dimensions with 48 items, which was finalized to five dimensions with 38 items after reliability and validity testing and analysis. The five dimensions included implementation of intraoperative acquired pressure injuries prevention, intraoperative acquired pressure injuries preventing cognitive conditions, preoperative intraoperative acquired pressure injuries preventing cognitive conditions, basic knowledge of pressure injuries, and implementation of intraoperative acquired pressure injuries prevention in special patients. Cronbach's α of the overall questionnaire was 0.969 while that of each dimension was 0.846-0.959. The KMO value of structural validity was 0.945 (P < 0.001), and the contribution rate of cumulative variance was 70.694%. The fitting of confirmatory factor analysis was found to be generally ideal: χ2/df = 2.382, RMR = 0.027, TLI = 0.894, RMSEA = 0.072, IFI = 0.905, CFI = 0.904.

Conclusions

The study and design of the questionnaire for operating room nurses on the current status of awareness and implementation of the prevention of intraoperative acquired pressure injuries are scientific and rational, providing a scientific basis for the standardized reform of hospitals and the optimization of the intraoperative acquired pressure injuries management system of the operating room.

Measuring patients' experiences of continuity of care in a primary care context-Development and evaluation of a patient-reported experience measure

BACKGROUND

Continuity of care is viewed as a hallmark of high-quality care in the primary care context. Measures to evaluate the quality of provider performance are scarce, and it is unclear how the assessments correlate with patients' experiences of care as coherent and interconnected over time, consistent with their preferences and care needs.

AIM

To develop and evaluate a patient-reported experience measure of continuity of care in primary care for patients with complex care needs.

METHOD

The study was conducted in two stages: (1) development of the instrument based on theory and empirical studies and reviewed for content validity (16 patients with complex care needs and 8 experts) and (2) psychometric evaluation regarding factor structure, test-retest reliability, internal consistency reliability, and convergent validity. In all, 324 patients participated in the psychometric evaluation.

RESULTS

The Patient Experienced Continuity of care Questionnaire (PECQ) contains 20 items clustered in four dimensions of continuity of care measuring Information (four items), Relation (six items), Management (five items), and Knowledge (five items). Overall, the hypothesized factor structure was indicated. The PECQ also showed satisfactory convergent validity, internal consistency, and stability.

CONCLUSION/IMPLICATIONS

The PECQ is a multidimensional patient experience instrument that can provide information on various dimensions useful for driving quality improvement strategies in the primary care context for patients with complex care needs.

PATIENT OR PUBLIC CONTRIBUTION

Patients have participated in the content validation of the items.

Development and initial validation of the staff perception of residential care environments (SPORE) instrument

BACKGROUND

The impact of the physical environment on healthcare staff well-being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people.

OBJECTIVES

To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE).

DESIGN

An instrument development and psychometric evaluation study.

METHODS

Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire-based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level.

RESULTS

The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person-centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment.

CONCLUSION

The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high-quality care.

IMPLICATIONS FOR PRACTICE

The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work.

Risk Perception Scale of Disease Aggravation for older patients with non-communicable diseases: Instrument development and cross-sectional validation study

AIM

The present study aimed to develop the Risk Perception Scale of Disease Aggravation for older patients with non-communicable diseases and evaluate its psychometric properties.

DESIGN

Instrument development and cross-sectional validation study were conducted.

METHODS

This study contained four phases. In phase I, a systematic literature review was conducted to identify the conception of disease aggravation and risk perception. In phase II, a draft scale was formulated from face-to-face semi-structured in-depth interviews by Colaizzi's seven-step qualitative analysis method and group discussions among the researchers. In phase III, domains and items of the scale were revised in accordance with the suggestions from Delphi consultation and patient feedback. In phase IV, psychometric properties were evaluated.

FINDINGS

Exploratory and confirmatory factor analyses determined four structural factors. Convergent and discriminant validities were acceptable because the average variance extracted coefficients ranged from .622 to .725, and the square roots of the average variance extracted coefficients for the four domains were larger than those of bivariate correlations between domains. The scale also exhibited excellent internal consistency and test-retest reliability (Cronbach's alpha coefficient = .973, intraclass correlation coefficient = .840).

CONCLUSIONS

Risk Perception Scale of Disease Aggravation is a new instrument that measures the risk perception of disease aggravation for older patients with non-communicable diseases, including possible reason, serious outcome, behaviour control and affection experience. The scale contains 40 items that are scored on a 5-point Likert scale, and it has acceptable validity and reliability.

IMPACT

The scale is applied to identify different levels of risk perception of disease aggravation for older patients with non-communicable diseases. Clinical nurses can provide targeted interventions to improve older patients' risk perception of disease aggravation based on levels of risk perception during hospitalization and the period before discharge.

PATIENT OR PUBLIC CONTRIBUTION

Experts provided suggestions for revising the scale dimensions and items. Older patients participated in the scale revision process to improve the wording of the scale.

The female self-advocacy in Cancer Survivorship scale is a psychometrically sound measure of self-advocacy in male cancer survivors

OBJECTIVE

To develop and psychometrically evaluate an adapted version of the Female Self-Advocacy in Cancer Survivorship (FSACS) Scale in men with a history of cancer.

METHODS

This psychometric instrument development and validation study used a two-phase approach to first adapt the FSACS Scale items to reflect the experience of men with a history of cancer and then evaluate the psychometric properties of the adapted scale compared to the original FSACS Scale. The study was conducted from December 2018 through April 2022 through cancer clinics, patient registries, and national advocacy organizations. We evaluated scale reliability and validity using reliability coefficients, exploratory and confirmatory factor analyses, and item analyses to determine a final set of scale items.

RESULTS

Item responses from N = 171 men with a history of cancer were evaluated to determine scale validity. After removing poor-performing items based on item-level analyses, factor analyses confirmed that a 3-factor structure of both the adapted and original FSACS Scale best fit the scale. The 10 new items did not outperform the original 20-item scale and were therefore excluded from the final scale. The final 20-item scale explained 87.94% of item variance and subscale's Cronbach α varied from 0.65 to 0.86.

CONCLUSION

The SACS Scale can be used in research and clinical contexts to assess the propensity of men and women to get their needs, values, and priorities met in the face of a challenge.

Assessment of Quality of Life in Gestational Diabetes Mellitus Care-Study Protocol of the GDM-QOL Project

In recent years, the concept of quality of life (QoL) has gained significant importance within health care and clinical research, e.g., as in patient-reported outcomes. In gestational diabetes mellitus (GDM) care, enhancing QoL through reasonable interventions is considered equally important as achieving metabolic control and preventing complications in the treatment process, leading to the suggestion that QoL assessment should be implemented as a clinical standard in GDM care. Although a considerable number of questionnaires for the measurement of general as well as health-related and diabetes-specific QoL are frequently used in GDM research, a validated QoL questionnaire tailored to women with GDM does not exist in German-speaking countries. To develop and test such an instrument, we plan to conduct the following steps: (a) translate the Persian questionnaire GDMQ-36, the only GDM-specific questionnaire to date; (b) conduct expert ratings as well as pretests featuring cognitive debriefings and structured interviews with women suffering from GDM for evaluating comprehensibility, face and content validity; (c) pilot and validate the preliminary questionnaire in terms of testing its psychometric performance (e.g., via confirmatory factor analysis). The resulting GDM-specific questionnaire will facilitate a broader perspective of the pregnant women's expectations, needs, impairments, and burdens related to their disease, and its treatment. This enables physicians and other health professionals to establish an individualized treatment plan and to provide customized information, support, and psychological counseling, which helps to optimize the provided care.

Development of a resource-use measure to capture costs of diabetic foot ulcers to the United Kingdom National Health Service, patients and society

Background

Diabetic foot ulcers (DFUs) add a significant burden to the lives of people with diabetes in the United Kingdom. They can have a considerable impact on a patient's daily life, with treatment requiring frequent changes of dressings and clinic attendances. Nurses and other allied health professionals (AHPs) within the community provide most wound care representing the primary cost driver.

Aims

To collaboratively explore key resource use related to the management of DFUs to develop, and pilot, a participant-reported measure to inform economic evaluations.

Methods

A literature search and semi-structured interviews determined health and non-health resource use in management of DFUs. A consensus view of the selected items was established in a modified Delphi study and further tested for acceptability and validity in a pilot study.

Results

Primary care consultations with a podiatrist or orthotist, district nurse visits, out-of-hours and emergency care, scans and investigations, and consumables provided in clinics were rated as the most important resource use items.

Conclusions

This work has informed the development of a measure that captures resource use considered important by the people most affected by DFUs; patients, family members and carers, and the healthcare professionals key to DFU management.

The Medical Outcome Study Social Support Survey (MOS-SSS): A psychometric systematic review

AIMS

To evaluate and synthesize psychometric properties of the MOS-SSS and to identify quality versions of MOS-SSS for use in future research and practice.

DESIGN

A psychometric systematic review.

DATA SOURCES

Articles about the translation, adaptation, or validation of the MOS-SSS in Medline, PubMed, CINAHL, and Web of Science and their reference lists published before 11 November 2022.

REVIEW METHODS

The review followed the Consensus Standards for the Selection of Health Measurement Instruments guidelines.

RESULTS

The review included 35 articles. Eleven versions of MOS-SSS (3, 4, 5, 6, 8, 12, 13, 16, 18, 19, and 22 items) have been validated in various populations and 13 languages. Of 14 studies developing a translated version of MOS-SSS, four studies performed both an experts' evaluation of content validity and a face validity test; two studies reported translation evaluation in the form of a content validity index. Of 35 studies, six performed both exploratory factor analysis and confirmatory factor analysis for structural validity; hypotheses and measurements for construct validity testings were often not clearly stated; two examined criterion validity; and four assessed cross-cultural validity. Internal consistency reliabilities were commonly examined by calculating Cronbach's alpha and reported satisfactory. Five studies analysed test-retest reliabilities using intra correlation coefficient. Methodological concerns exist.

CONCLUSION

The English 19-item, Farsi Persian 19-item, and Vietnamese 19-item versions are recommended for future use in research and practice. Italian 19-item and Malaysian 13-item versions are not recommended to be used in future research and practice. All other versions considered in this review have potential use in future research and practice. Proper procedures for developing a translated version of MOS-SSS and validating the scale are recommended.

IMPACT

The review identified quality versions of MOS-SSS to measure social support in future research and practice. The study also indicated methodological issues in current validation studies. Application of the study findings and recommendations can be useful to improve outcome measurement quality and maximize the efficiency of resource use in future research and practice.

NO PATIENT OR PUBLIC CONTRIBUTION

This systematic review synthesized the evidence from previous research and did not involve any human participation.

Psychometric Validation and Meaningful Change Thresholds of the New Nasal Polyposis Symptom Diary

OBJECTIVES

The Nasal Polyposis Symptom Diary (NPSD) is a novel and short patient-reported outcome (PRO) tool specifically developed to assess important and relevant symptoms reported by patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). We evaluated the psychometric properties of 4 predefined NPSD-derived scores intended to support symptom-improvement assessments of investigational therapies for inclusion in product labeling.

METHODS

Five hundred eighteen patients with severe CRSwNP from a Phase III clinical trial (NCT03401229) completed the NPSD, comprising 11 items: 8 symptom-specific, 2 symptom-impact, and 1 optional medication-compliance. The psychometric characteristics of 3 single-item symptom scores (Nasal Blockage Score [NBS], Nasal Congestion Score [NCS], and Difficulty with Sense of Smell Score [DSS]) and a Total Symptom Score (TSS, summary of the 8 symptom-specific items) were evaluated for reliability, validity, and ability to detect change. Within-patient meaningful change thresholds (MCTs) were established using anchor- and distribution-based methods. Comparative PROs included the 22-item Sino-Nasal Outcome Test (SNOT-22) and Patient Global Impression of Severity (PGI-S).

RESULTS

The TSS exhibited strong internal consistency (Cronbach α = .88) and test-retest reliability (intraclass correlation coefficient >.80). Correlation between the TSS and SNOT-22 total score indicated good convergent validity (r = .70). All 4 NPSD scores demonstrated known-groups validity (significant differences among subgroups of patients with predetermined disease severity levels based on PGI-S categories) and were sensitive to detect change in patients' clinical status (significant differences among subgroups of patients with reported changes between 2 time-points in PGI-S and Patient Global Impression of Change scores). MCTs for improvement were established at 1.0 point for NBS, NCS, and DSS, and 4.0 points for TSS.

CONCLUSION

These findings support the reliability, validity, and suitability of the 4 NPSD-derived scores for evaluating treatment effect on CRSwNP symptoms and their use in clinical trials with predetermined MCTs for improvement.

Development of the Patient Advocacy Scale for Intensive Care Nurses

Background and Purpose: To describe the process of developing and validating the content of the Patient Advocacy Scale for Nurses in Intensive Care (EAPEnf-UTI). Methods: Methodological research. To achieve the elaboration objective, five stages were developed: (a) definition of the theme, (b) generation of the number of items, (c) determination of the measurement format, (d) validation of face and content, and (e) content adjustment. Results: The instrument elaborated from a survey and integrative literature review, and the measurement format chosen was the 5-point Likert scale. The validation of face and content was performed by expert judges and by pretest. The final instrument had 57 items. Conclusion: EAPEnf-UTI is a pioneering instrument built in the Brazilian context, whose future validation will allow the capturing of situations specific to intensive care units and the professional practice of intensive care nurses.

Development and Psychometric Testing of Task and Contextual Performance Scales for Clinical Nurses

Background and Purpose: This study aims to develop a task performance scale and a contextual performance scale for clinical nurses and to test the scales psychometrically. Methods: This study was carried out in two phases in a private hospital group. During the first phase, the initial scales were developed, and then the validity and reliability of the scales were analyzed; 154 nurses participated in the second phase. Results: The task performance scale consisted of two factors (total variance explained: 75.87%); the contextual performance scale consisted of three factors (total variance explained: 74.05%). The content validity indexes of both scales were 0.99. The Cronbach's alpha coefficients of both scales were 0.98. The test-retest reliability and inter-rater agreement of the scales were also good. Conclusions: The scales can contribute to nursing literature and hospital managers in assessing the performance of clinical nurses.

Development and Validation of the Lewy Body Disease Caregiver Activities Scale

Background and Purpose: Caring for someone with Lewy body disease (LBD) is difficult. This study describes the development and validity testing of the LBD Caregiver Activities Scale (LBD-CAS). Methods: Caregiver interviews informed the development of the LBD-CAS. Experts estimated the content validity of items (I-CVI) and provided feedback about the scale. Family caregivers evaluated items for face validity. Results: Expert I-CVI ratings yielded 49 items with scores of 0.83 or higher. Four items with I-CVI scores <.83 were retained due to conceptual significance. The overall scale CVI was 0.86. Items evaluated by caregivers for face validity showed excellent variability in responses, with no major ceiling or floor effects. Conclusions: LBD-CAS showed evidence of content and face validity for the assessment of activities performed by LBD caregivers. Further psychometric testing is recommended.

Compassion in health professionals: Development and validation of the Capacity for Compassion Scale

BACKGROUND

Health professionals witness pain and suffering when they care for sick people and their families. Compassion is a necessary quality in their work as it combines the will to help, alleviate suffering and promote the well-being of both the people they are attending and the professionals themselves. The aim of the study was to design and evaluate the psychometric properties of the Capacity for Compassion Scale (CCS).

DESIGN

A quantitative, descriptive and cross-sectional study was carried out to evaluate the psychometric properties of the scale (reliability, temporal stability, content validity, criterion validity and construct validity).

METHODS

The study was carried out in two phases: pilot study and final validation. The data were collected between April and May 2022. The sample was selected by convenience sampling and was made up of a total of 264 participants, 59 in the pilot phase and 205 in the final validation.

RESULTS

The Capacity for Compassion Scale has been shown to have good psychometric properties in relation to reliability, temporal stability, and content, criterion, and construct validity. Factor analysis showed that there were four subdimensions of the scale: motivation/commitment, presence, shared humanity and self-compassion. The results also indicate that compassionate ability is significantly correlated with age and work experience.

CONCLUSIONS

The Capacity for Compassion Scale shows adequate psychometric properties. This instrument measures the compassion capacity of health professionals, which is a valuable discovery for new lines of research in this field.

IMPACT

Through this scale, low levels of capacity for compassion can be detected that negatively influence the quality of care provided by health professionals. The Capacity for Compassion Scale can therefore contribute to the identification of needs and promote training around compassion for health professionals.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. WHAT PROBLEM DID THE STUDY ADDRESS?: Compassion in health professionals has positive effects on improving the quality of care, the satisfaction of professionals and the work environment. There are compassion cultivation programmes whose validity has been proven for the development of the dimensions of compassion. There is no specific instrument that measures capacity for compassion in healthcare professionals. WHAT WERE THE MAIN FINDINGS?: A scale is designed to measure capacity for compassion in health professionals. This is the only such scale available up until now. The scale measures four dimensions of compassion: motivation/commitment, presence, shared humanity and self-compassion. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The development of specific programmes that can increase the compassion of health professionals with all the benefits that this can bring to health care is encouraged. It will be possible to analyse the effects of training programmes on the cultivation of compassion.

The five aspects mealtime environment observation instrument for assessing mealtime environments in nursing homes: Development and validation

AIMS AND OBJECTIVES

To further develop and validate the Mealtime instrument, an observational instrument for assessing mealtime environments in nursing homes originating from the theoretical framework: Five Aspects Meal Model (FAMM).

METHODOLOGICAL DESIGN AND JUSTIFICATION

A mealtime experience is significant for a sense of well-being. In nursing homes, residents' personal preferences, combined with their diagnoses and different stages of illness, influence their mealtime experience and provide a complexity that has been found difficult to assess. Using FAMM, a theoretical framework as its base, this study, attempts to look at different parts of the mealtime environment. FAMM structures the mealtime environment in to five aspects: room, meeting, product, management control system and atmosphere. This study's design includes instrument development and validation.

ETHICAL ISSUES AND APPROVAL

This study has been approved by the Swedish Ethical Review Authority (dnr 2019-05477).

DESIGN

Methodological study.

RESEARCH METHOD

An existing instrument, the Mealtime instrument with FAMM as a theoretical framework, was used as a foundation for the development of the Five Aspects Mealtime Environment Observation Instrument (FAME-OI). Content validity index (CVI) was used to validate FAME-OI.

RESULTS

FAME-OI's item-CVI, scale-CVI and modified Kappa displayed high validity. Changes were made in its structure and phrasing. These developments resulted in having a distinct structure in FAME-OI, in reference to FAMM.

CONCLUSION

FAME-OI is applicable for clinical use in nursing homes and in research; however, adjustments may be needed before its use in other health care facilities.

Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex

Chemsex is understood as "the intentional use of stimulant drugs to have sex for an extended time among gay, bisexual, and other men who have sex with men". It is a public health problem because of the increased incidence of cases and because of the consequences on the physical and mental health of those who practice it.

AIM

This study aimed to analyze, with the help of the Delphi method, the content validity of a new instrument to assess the risk of behaviors associated with the chemsex phenomenon.

METHOD

First, a bank of items identified from the literature was elaborated. Secondly, 50 experts with knowledge of the chemsex phenomenon at the national level were contacted. A Delphi group was formed with them to carry out two rounds of item evaluation. The linguistic evaluation (comprehension and appropriateness) was assessed using a Likert scale from 1 to 5 for each item. Items that did not reach a mean score of 4 were eliminated. Content assessment was calculated using each item's content validity index (CVI) and Aiken's V (VdA). A minimum CVI and VdA value of 0.6 was established to include the items in the questionnaire.

RESULTS

A total of 114 items were identified in the literature. In the first round of Delphi evaluation, 36 experts evaluated the items. A total of 58 items were eliminated for obtaining a CVI or VdA of less than 0.6, leaving 56 items. In a second Delphi round, 30 experts re-evaluated the 56 selected items, where 4 items were eliminated for being similar, and 10 items were also eliminated for not being relevant to the topic even though they had values higher than 0.6, leaving the scale finally composed of 52 items.

CONCLUSION

A questionnaire has been designed to assess the risk of behaviors associated with the chemsex phenomenon. The items that make up the questionnaire have shown adequate content and linguistic validity. The Delphi method proved to be a helpful technique for the proposed objective.

The development of a parent report instrument of early communication and language skills of infants and toddlers in mainland China

OBJECTIVE

This study was designed to produce a new parent-report measure, the Diagnostic Receptive Expressive Assessment of Mandarin-Infant Toddler Assessment of Communication and Language (DREAM-IT) in order to provide norms for the developmental skills of children aged 0-36 months in four areas: expressive language, receptive language, cognitive play and social skills.

METHODOLOGY

The scale was designed to be both broader and deeper than existing instruments that neglect one or more of these significant domains involved in early language. Items were chosen by a group of specialists with clinical experience working with the age group and with attention to the developmental literature. Caregivers were tested individually by a trained person who asked the questions and provided examples. In addition to an extensive health questionnaire, caregivers answered questions in Mandarin about their child's behaviour using a scale of 'not yet', 'sometimes' or 'always' or listing out words and/or sounds understood or said by the child. The 476 participating caregivers were recruited at maternal and child healthcare clinics centred in Chengdu, China, 191 of whom were tested a second time seven months later. The children were sampled in three-month age-bands from 0 to 36 months. The sample was balanced for child gender by age band, and parental education was balanced. Caregivers of 0-24-month-old children and caregivers of 12-36 months were each asked a different set of questions, to determine the appropriate age range and cutoff points for each question, requiring the sample size to be doubled for children aged 12-24 months.

RESULTS

The results were subject to item-response theory analysis to remove outlying items, and the resulting internal reliability was high for each domain (average Cronbach's alpha=0.87). The final instrument (between 67 and 113 questions in total) was refined to include the least redundant questions that had the highest intercorrelations, with attention paid to coverage of all domains across the age range. Two scales were developed: one for children 0-18 months, the second for children aged 18-36 months. The longitudinal design permitted the creation of growth curves and norms for each domain for six-month intervals from 0 to 36 months. A small sample of 32 parents of children with Down syndrome aged 18-36 months provided validation that the scales are highly sensitive to developmental delay.

CONCLUSION

The instrument shows considerable promise for detecting early communication problems in children in China.

WHAT THIS PAPER ADDS

What is already known on the subject In China, efforts were made in recent years to develop language assessments for infants and toddlers, but limitations existed with the domains included and number of items included per age group. Many clinical practitioners also continued to rely on language subtests of general developmental scales, which were limited in depth and breadth of language skills tested and were never intended for diagnosis of language delay. What this paper adds to existing knowledge This paper discusses the development of a valid caregiver report instrument for early communication and language skills of infants and toddlers in mainland China. The Diagnostic Receptive Expressive Assessment of Mandarin-Infant Toddler (DREAM-IT) includes foundational domains necessary for language and communication development in young children (receptive language, expressive language, cognitive play and social communication domains). The results show strong internal reliability (Cronbach's alpha) for each domain on a sample of 716 children sampled in three-month age bands from 0 to 36 months. The external validity proved strong when tested on a group of 32 young children with Down syndrome. What are the potential or actual clinical implications of this work? Besides helping to inform the diagnosis of language delays in infants and toddlers in China, the caregiver report instrument has special features to support clinical practitioners in a field that is just emerging in China. The unique support features include the automatic generation of a profile of relative strengths and weaknesses of the child on the report and the recommendation of child-specific caregiver coaching videos on a companion app.

Validation of the Simplified Chinese Palliative Care Nursing Self-Competence Scale: Two Cross-sectional Studies

BACKGROUND

Due to the increasing burden of life-limiting illnesses, the need for palliative care has increased. Nurses' palliative care competence is a vital factor in improving its accessibility. A reliable instrument is needed to measure nurses' competence in providing palliative care.

OBJECTIVE

Our aim was to translate and culturally adapt the Palliative Care Nursing Self-Competence Scale (PCNSC) into the Palliative Care Nursing Self-Competence Scale-Simplified Chinese (PCNSC-SC).

METHODS

Two cross-sectional studies were conducted after content validity had been confirmed during the instrument's translation and adaption. The convergent validity, construct validity, internal consistency, and homogeneity were evaluated in both the first and second studies. Test-retest reliability was assessed only in the first study. Clinical nurses who had a registered nurse qualification certificate and at least 12 months of work experience from a tertiary hospital in Hubei, China participated in the 2 studies.

RESULTS

The PCNSC-SC contains 8 dimensions and 34 items, based on goodness-of-fit indices and confirmatory factor analysis. The Cronbach's alpha of the PCNSC-SC was .984 and .990 in the 2 studies, respectively. The test-retest reliability of the PCNSC-SC after 2 weeks was .717.

CONCLUSION

The PCNSC-SC can be used to evaluate perceived self-competence in palliative care of Chinese nurses with good reliability and validity.

Use of the Smart Excretion Care System Linked to Electronic Medical Records to Alleviate Nursing Burden and Enhance Patient Convenience: Mixed Methods Study

BACKGROUND

The surge in older demographics has inevitably resulted in a heightened demand for health care, and a shortage of nursing staff is impending. Consequently, there is a growing demand for the development of nursing robots to assist patients with urinary and bowel elimination. However, no study has examined nurses' opinions of smart devices that provide integrated nursing for patients' urinary and bowel elimination needs.

OBJECTIVE

This study aimed to evaluate the feasibility of the Smart Excretion Care System tethered to electronic medical records in a tertiary hospital and community care setting and discuss the anticipated reductions in the burden of nursing care.

METHODS

Focus group interviews were conducted using the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. The interviews were conducted in March 2021 and involved 67 nurses who had worked at Seoul National University Bundang Hospital for more than 1 year and had experience in assisting patients with excretion care. Data were collected using purposive and snowball sampling methods.

RESULTS

A total of four themes relevant to the Smart Excretion Care System were found: (1) expected reductions in the burden of nursing care, (2) applicable indications (by departments and diseases), (3) preferred features/functions, and (4) expected benefits of using the Smart Excretion Care System in clinical facilities. Nurses from comprehensive nursing care wards had the highest burden when it came to excretion care. It was a common opinion that the Smart Excretion Care System would be very useful in intensive care units and should be applied first to patients with stroke or dementia.

CONCLUSIONS

Excretion care is one of the most burdensome tasks for nurses, increasing their workload. The development of the Smart Excretion Care System as a digital health intervention could help improve nurses' work efficiency, reduce their burden, and extend to caregivers and guardians.

Development and psychometric properties of the Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines

Background

Over the years, a few tools and instruments have been developed to assist in the assessment within a palliative care setting. However, many of these tools and instruments do not reflect a person-centered palliative care model.

Objective

This study aims to develop a Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines.

Methods

An exhaustive search of the literature was conducted to develop a pool of items for the instrument. The validity of the instrument was evaluated using the content validity index (CVI), while the factor structure was assessed using exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation. Also, the internal reliability was evaluated using Cronbach's alpha.

Results

EFA yielded three factors: 1) Caring as maintaining person's dignity (13 items), 2) caring as empowerment of person's autonomy (14 items), and 3) caring as understanding person's momentary concerns (10 items). Whereas the internal consistency reliability of these subscales appeared excellent (i.e., 0.95, 0.96, and 0.93, respectively), the Cronbach's alpha for the overall scale was 0.98. The item-total correlation coefficients were >0.30 for all items, ranging from 0.310 to 0.726.

Conclusion

Findings support a three-factor, 37-item PPCNI that can be used in clinical practice to ensure that nurses provide palliative care based on patient needs and preferences.

SI-CBPAR: Towards structural indicators of community-based participatory action research

INTRODUCTION

Structural aspects of community-engaged research are not well measured yet have critical implications for community research empowerment. This is particularly so with people who use drugs. We introduce the Structural Indicators of Community-Based Participatory Action Research (SI-CBPAR) to measure structural indicators of community-research entity relationships.

METHODS

A three-phased process of iterative development, feasibility and applicability assessment was used to examine the instrument with community-engaged studies as a first stage of instrument development. The development team included people with university, non-government organisation and lived/ing drug use experience. Four studies on the health of people who use drugs were reviewed for indicator evidence followed by iterative discussion about construct and item discrepancies. Indicators were measured for the degree to which they were observed using a three-point scale.

RESULTS

All but two constructs were confirmed for meaning. Constructs of 'community' and 'coalition' required revision and explanation. The need for further exploration of power differentials between community and community-based organisations was identified. Indicator evidence was found for all six categories across studies. The instrument was deemed applicable and easy to use. It was observed that categories could apply to studies with various degrees of community engagement and to other research focal areas.

DISCUSSION AND CONCLUSIONS

SI-CBPAR applicability testing and initial category confirmation indicate its potential utility for community research collaboratives. The next phase of development involves cognitive interviewing with researchers from across community engaged research orientations, and with communities engaged in research beyond drug user health.

Refining and psychometric evaluation of the falling risk assessment tool in ophthalmology inpatients

AIMS

The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties.

DESIGN

A cross-sectional design was used.

METHODS

A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis.

RESULTS

Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I-CVI was 0.75-1.00, the S-CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients.

PATIENT OR PUBLIC CONTRIBUTION

After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions.

The development of the Therapeutic Group Context Questionnaire: Reliability and validity measures based on telehealth Group-based Pain Management Programs

INTRODUCTION

In 2016, the Centers for Disease Control and Prevention analyzed the National Health Interview Survey data and found that the occurrence of chronic pain and high-impact chronic pain in the USA was 20.4% and 8%, respectively. Group-based Pain Management Programs have been viewed as significant treatments aiding patients with self-management of chronic pain. The onset of coronavirus disease 2019 (COVID-19) at the beginning of 2020, widely eliminated the in-person Group-based Pain Management Programs. The exploration of therapeutic contextual factors such as the therapeutic alliance and group dynamics in telehealth Group-based Pain Management Programs appears warranted for which reason the Therapeutic Group Context Questionnaire was developed.

METHODS

The therapeutic alliance and group dynamics items in the Therapeutic Group Context Questionnaire were developed from an extensive literature review and underwent examination of content validity, internal consistency, reliability, and validity through telehealth Group-based Pain Management Programs.

RESULTS

Content validity of the Therapeutic Group Context Questionnaire was established in five separate stages and the psychometrics of the Therapeutic Group Context Questionnaire was found to be very good with high internal consistency and reliability (r = 0.85-0.97) and the ability of the Therapeutic Group Context Questionnaire to differentiate between high and low scorers on the SF-36 emotional well-being measure.

DISCUSSION

The examination of therapeutic contextual factors via telehealth Group-based Pain Management Programs using the Therapeutic Group Context Questionnaire appears possible in view of the very good psychometric properties described above. Investigation of therapeutic contextual factors through the Therapeutic Group Context Questionnaire may provide greater insight into the role that these factors may have in telehealth programs and their impact on pain outcomes. Future investigation of the Therapeutic Group Context Questionnaire in non-telehealth Group-based Pain Management Programs, as well as, other disorders being addressed via telehealth appears warranted.

Development and psychometric testing of the perception of nursing profession instrument

BACKGROUND

Perceptions of the nursing profession influence career choices in nursing. An unrealistic perception might lead students to drop out of nursing education programmes. Objective measurement of the nursing applicants' perceptions at the student selection stage could enhance their career choices in nursing.

AIM

To develop and psychometrically evaluate the Perception of Nursing Profession Instrument (PNPI).

DESIGN

Mixed method design.

METHOD

Two versions of the PNPI were developed during the years 2016-2022. The first version was based on documents describing the nursing profession and the second version was based on an integrative literature review, a focus groups study and a document analysis of descriptions of the nursing profession. The meta-ethnographic approach was used to synthesize the results and form a theoretical framework for developing the PNPI (60 items). Item content validity was evaluated by an expert panel of nurses (n = 7). The psychometric properties of the instrument were analysed using the item response theory approach.

RESULTS

The development process resulted in the 40-item PNPI with the following subscales: the content of nursing work, the career in nursing, the nature of nursing work and the characteristics of a nurse. The psychometric analysis revealed unidimensionality and goodness of fit to the partial credit model; however, the item difficulty was not well matched with the participants' abilities.

CONCLUSION

The PNPI is a novel instrument for objectively measuring perceptions of the nursing profession. For further development, item difficulty must be enhanced to improve the measurement accuracy of the nursing applicants' perceptions of the nursing profession.

IMPACT

Perceptions of the nursing profession influence career choices, but there is a lack of objective assessment instruments that can be used in nursing student selection setting to measure the perception. The results of this study offer an instrument to measure perception, while also suggesting ideas for further development.

Modernizing Measure of the Nurse Work Environment

BACKGROUND

Research has established a relationship between favorable nurse work environments and better nurse, patient, and organizational outcomes. However, the instrument most frequently used to measure the nurse work environment, the Practice Environment Scale of the Nursing Work Index (PES-NWI), has not had its items significantly re-evaluated since the 1980s.

OBJECTIVE

We sought to examine the psychometric properties of an updated PES-NWI and create an instrument suitable for further testing and refinement to measure the present-day nurse work environment. Specifically, we sought to establish construct, structural, discriminative, and concurrent validity. For reliability, we desired to establish interrater reliability and internal consistency reliability.

METHODS

We administered a modified PES-NWI to a national sample of direct-care hospital nurses (n = 818) in the United States. We then assessed the psychometric properties of the instrument.

RESULTS

While the modified PES-NWI displayed adequate validity and reliability properties, further testing and refinement of the instrument is necessary.

CONCLUSIONS

With this updated measure of the nurse work environment, researchers and hospital leaders can identify modifiable opportunities for improvement in contemporary hospital nurse work environments which may enhance nurse and patient outcomes.

Development and Psychometric Properties of a Scale Measuring Barriers to Perioperative Hypothermia Prevention for Anesthesiologists and Nurses

PURPOSE

To develop a scale that measures barriers to perioperative hypothermia prevention (BPHP) as perceived by anesthesiologists and nurses.

DESIGN

A methodological and prospective psychometric study.

METHODS

Based on the theoretical domains framework, the item pool was created through a literature review, qualitative interviews, and expert consultation. The scale was pretested with a sample of 154 key stakeholders in perioperative temperature management and then field tested with 416 anesthesiologists and nurses working at three hospitals in Southeast China. Item analysis, and reliability and validity analysis were performed.

FINDINGS

The average content validity index was 0.94. According to exploratory factor analysis, seven factors were obtained that could explain 70.283% of the total variance. Confirmatory factor analysis showed excellent or acceptable goodness-of-fit indices. The reliability analysis demonstrated that the scale had high internal consistency and temporal stability, with Cronbach's α, split-half coefficient and test-retest values of 0.926, 0.878 and 0.835, respectively.

CONCLUSIONS

The BPHP scale meets the psychometric criteria for reliability and validity and promises to be a useful quality measure for IPH management during the perioperative period. Further investigations on educational or resource needs and the development of an optimal perioperative hypothermia prevention protocol to narrow the gap between research evidence and clinical practice should be performed.

Measuring person-centred pain management: Development of a questionnaire using the fundamentals of care framework

AIM

To develop and test a questionnaire using the Fundamentals of Care framework to measure person-centred pain management.

DESIGN

Cross-sectional exploratory descriptive design.

METHODS

Development in three phases: (a) literature search for questionnaires measuring person-centred pain management, (b) seven-step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the 'Strategic and Clinical Quality Indicators in Postoperative Pain management' questionnaire, the Fundamentals of Care framework and person-centredness principles. Theoretical experts (n = 2) reviewed the questionnaire, further evaluated by providers (n = 5) and patients (n = 5) using a think-aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital.

RESULTS

The evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person-centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18-89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement.

CONCLUSION

This first attempt at transforming the essential components of person-centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person-centred pain management in acute surgical care, to relieve the patient from pain.

PATIENT OR PUBLIC CONTRIBUTION

Patients and providers were involved in testing the questionnaire.

Development and psychometric evaluation of the nurses' Work Values Scale

AIM

This study aimed to develop the nurses' Work Values Scale (WVS) to determine how important certain values are for nurses and to psychometrically test the scale.

DESIGN

Instrument development and validation study.

METHOD

A two-phase scale development process comprising item generation, scale improvement and psychometric property evaluation was used. In the first phase, scale items were identified. In the second phase, item and exploratory factor analyses were performed in Study 1, and confirmatory factor analysis, validity verification and reliability verification of the nurses' WVS were performed in Study 2.

RESULTS

As a result of the analysis, a scale of 30 items with four subdomains was developed. In convergent validity and reliability verification, it was shown that the nurses' WVS has acceptable validity and reliability.

NO PATIENT OR PUBLIC CONTRIBUTION

Patients or members of the public were not involved in this study.

Measuring what matters in healthcare: a practical guide to psychometric principles and instrument development

The provision of quality healthcare relies on scales and measures with robust evidence of their psychometric properties. Using measurement instruments with poor reliability, validity, or feasibility, or those that are not appropriate for the target diagnostic group or construct/dimension under consideration, may be unfavorable for patients, unproductive, and hinder empirical advancement. Resources from the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) group can assist in identifying and developing psychometrically sound measures. The COSMIN initiative is the only international, research-based practice taxonomy and methodological guidelines for measurement in healthcare. This manuscript aims to provide an accessible introduction to theories, principles and practices of psychometrics, instrument properties, and scale development, with applied examples from the COSMIN recommendations. It describes why measurement in healthcare is critical to good practice, explains the concepts of the latent variable and hypothetical construct and their importance in healthcare assessments, explores issues of flawed measurement and briefly explains key theories relevant to psychometrics. The paper also outlines a ten-step process to develop and validate a new measurement instrument, with examples drawn from a recently developed visuoperceptual measure for analysis of disordered swallowing to demonstrate key concepts and provides a guide for understanding properties of and terminology related to measurement instruments. This manuscript serves as a resource for healthcare clinicians, educators, and researchers who seek to develop and validate new measurement instruments or improve the properties of existing ones. It highlights the importance of using psychometrically sound measurement instruments to ensure high-quality healthcare assessments.

Development of a Pediatric Behavioral Early Warning Scale (Pedi-BEWS) for Children

Background and Purpose: The prevention of aggressive behavior in child and adolescent inpatient settings is essential. However, it can be difficult to prompt a quick appropriate intervention without an early warning scale for the prevention and management of behavioral emergencies in a psychiatric inpatient adolescent unit. Behavioral emergencies often result in restraint/seclusion and/or administration of psychotropic medications. The objectives are to develop and evaluate the Pediatric Behavioral Early Warning Scale (Pedi-BEWS) as a screening tool to prompt quick appropriate interventions and to decrease incidents of restraint/seclusion and/or administration of psychotropic medications. Methods: A two-phase methodological design was applied. A total of 447 inpatients and 21 nurses were used to test internal consistency reliability and validity. Results: Receiver operating characteristic curve areas for the developed instrument were calculated to be 0.890 (cognition), 0.959 (affect), and 0.951 (behavior). The overall Pedi-BEWS indicated high reliability (Cronbach's alpha = .98). Conclusions: The Pedi-BEWS shows high internal consistency and validity. The use of the newly developed tool may reduce or eliminate episodes of seclusion and restraint for pediatric patients with a behavioral problem. In addition, the tool has the potential to enhance psychiatric nurses' assessment skills and competencies. The use of the newly developed Pedi-BEWS can promote an appropriate and timely nursing assessment and intervention before the deterioration in psychiatric nursing practice.

Linguistic Validation of Genomic Nursing Concept Inventory to Finnish Applying Mandysova's Decision Tree Algorithm

Background and Purpose: Currently, there is no available Finnish version of the Genomic Nursing Concept Inventory tool (GNCI). This study tested the validity, reliability, and clinical usability of a Finnish translation. Methods: A decision tree algorithm was used to guide the translation, as per International Society for Pharmacoeconomics and Outcomes Research guidelines. Item-Content Validity Index (I-CVI), modified kappa (k*) statistics, and Cronbach's alpha were calculated. Results: The I-CVI and k* values were "good" to "excellent" (I-CVI = 0.63-1.00, k* = 0.52-1.00), and Cronbach's alpha value was "good" (α = 0.816; 95% confidence interval: 0.567-0.956). Conclusion: The Mandysova's decision tree algorithm provided clear and rigorous direction for the translation and validity of the Finnish GNCI.

Evaluating satisfaction with teaching innovation, its relationship to academic performance and the application of a video-based microlearning

AIM

To develop and validate a questionnaire to assess satisfaction with teaching innovation, assess the student satisfaction with a video-based microlearning intervention in its video-based modality and to verify its impact on academic performance.

DESIGN

A descriptive cross-sectional study was conducted. The study used the COSMIN checklist for studies on measurement instruments.

METHODS

One hundred and ten nursing students from Salus Infirmorum University Centre (Andalusia, Spain) participated in the study. The items of the instrument were designed based on a literature review and its validity and stability were analysed. After that, 6 weeks of video-based microlearning intervention were implemented. Then students were asked to fill the satisfaction questionnaire and then took the subject exam.

RESULTS

The resulting questionnaire consisted of 5 items with only one dimension. The questionnaire showed good validity and reliability. A direct correlation was observed between satisfaction with the video-based microlearning intervention and the marks of the subject exam.

Urinary Symptoms Among People With Neurogenic Lower Urinary Tract Dysfunction (NLUTD) Vary by Bladder Management

Objectives

To determine whether assessment and decision-making around urinary symptoms in people with neurogenic lower urinary tract dysfunction (NLUTD) should depend on bladder management.

Methods

Three surveys of urinary symptoms associated with NLUTD (USQNBs) were designed specific to bladder management method for those who manage their bladders with indwelling catheter (IDC), intermittent catheter (IC), or voiding (V). Each was deployed one time to a national sample. Subject matter experts qualitatively assessed the wording of validated items to identify potential duplicates. Clustering by unsupervised structural learning was used to analyze duplicates. Each item was classified into mutually exclusive and exhaustive categories: clinically actionable ("fever"), bladder-specific ("suprapubic pain"), urine quality ("cloudy urine"), or constitutional ("leg pain").

Results

A core of 10 "NLUTD urinary symptoms" contains three clinically actionable, bladder-specific, and urine quality items plus one constitutional item. There are 9 (IDC), 11 (IC), and 8 (V) items unique to these instruments. One decision-making protocol applies to all instruments.

Conclusion

Ten urinary symptoms in NLUTD are independent of bladder management, whereas a similar number depend on bladder management. We conclude that assessment of urinary symptoms for persons with NLUTD should be specific to bladder management method, like the USQNBs are.

The Cannabis Effects Expectancy Questionnaire-Medical (CEEQ-M): Preliminary psychometric properties and longitudinal validation within a clinical trial

The use of cannabis for medical symptoms is increasing despite limited evidence for its efficacy. Expectancies-prior beliefs about a substance or medicine-can modulate use patterns and effects of medicines on target symptoms. To our knowledge, cannabis expectancies have not been studied for their predictive value for symptom relief. The 21-item Cannabis Effects Expectancy Questionnaire-Medical (CEEQ-M) is the first longitudinally validated measure of expectancies for cannabis used for medical symptoms. The questionnaire was developed for a randomized clinical trial of the effect of state cannabis registration (SCR) card ownership on symptoms of pain, insomnia, anxiety, and depression in adults (N = 269 across six questionnaire administrations). Item-level analyses (n = 188) demonstrated between-person stability of expectancies and no aggregate, within-person expectancy changes 3 months after individuals gained access to SCR cards. Exploratory factor analysis (n = 269) indicated a two-factor structure. Confirmatory factor analysis at a later timepoint (n = 193) demonstrated good fit and scalar invariance of the measurement model. Cross-lagged panel models across 3 and 12 months (n = 187 and 161, respectively) indicated that CEEQ-M-measured expectancies did not predict changes in self-reported cannabis use; symptoms of pain, insomnia, anxiety, and depression; and well-being. However, greater baseline cannabis use predicted more positive expectancy changes. The findings suggest that the CEEQ-M is psychometrically sound. Future work should clarify at what timescales cannabis expectancies have predictive value and how cannabis expectancies for medical symptoms are maintained and diverge from other substance use expectancies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).