Development and psychometric testing of the actualisation of evidence-based nursing instrument

AIM

To describe the development of the Actualisation of Evidence-Based Nursing instrument targeted at nurses working in clinical practice (ActEBN-nurses), meant for evaluating the actualisation of individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations, and to test its validity and reliability.

DESIGN

Cross-sectional survey.

METHODS

The FinYHKÄ model was used as the theoretical background of the instrument development and supplemented with the JBI Model of Evidence-Based Healthcare, previous literature and items from a previous instrument, the Evidence-Based Practice Process Assessment Scale, with permission of the copyright holders. After two rounds of expert panel and piloting, a national survey was conducted with the instrument in 2021. The target group consisted of nurses working in clinical practice. Psychometric testing included internal consistency (Omega, item analysis) confirmatory factor analysis and t-test for comparison of two groups' differences (sensitivity).

RESULTS

A new instrument, ActEBN-nurses was developed, comprising two parts: Individual-level (32 items, 5-point Likert-scale) and Organisational-level support structures for evidence-based nursing (37 items, 5-point Likert-scale). In total, 1289 nurses participated in the survey. The ActEBN-nurses proved to have good internal consistency in both parts (Omega ω .931 and .966), structural validity and sensitivity based on the two educational levels within the sample. The structure of both parts was slightly modified, based on the CFA modification indices, considering the impact of the reverse worded items in part Individual and redundant items within both parts.

CONCLUSION

The ActEBN-nurses has promising psychometrics, and it can be used for evaluating individual and organisational-level support structures for evidence-based nursing within social and healthcare organisations.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Evaluation of the support structures within social and healthcare organisations is needed to recognise shortcomings in current structures and advance evidence-based nursing across different contexts.

REPORTING METHOD

The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Interpreting reliable change on the Spanish-language NIH toolbox cognition battery

This study applied a reliable change methodology to the test-retest data from the Spanish-language NIH Toolbox Cognition Battery (NIHTB-CB) normative sample. Participants included Spanish-speaking adults (n = 48; 54.2% women, 100% Latinx) evaluated twice within one to two weeks on the Spanish-language NIHTB-CB, consisting of two crystallized and five fluid cognitive tests. Test-retest means, standard deviations, and intraclass correlations were used to calculate upper and lower bounds of 70, 80, and 90% confidence intervals (CIs) around change scores, with these bounds used as cutoffs for inferring reliable change. Cutoffs were calculated for raw scores, age-adjusted standard scores (SS; M = 100, SD = 15), and demographic-adjusted T-scores (T; M = 50, SD = 10), adjusting for age, gender, and education. Test-retest change scores on the Spanish-language NIHTB-CB exceeding the following cutoffs indicate reliable change based on an 80% CI (i.e., values exceeding these cutoffs indicate greater decline or greater improvement than 90% of the sample): Dimensional Change Card Sort (SS ≥ 15/T ≥ 11), Flanker (SS ≥ 13/T ≥ 10), List Sorting (SS ≥ 13/T ≥ 9), Picture Sequence Memory (SS ≥ 14/T ≥ 9), Pattern Comparison (SS ≥ 14/T ≥ 10), Picture Vocabulary (SS ≥ 8/T ≥ 6), Oral Reading (SS ≥ 7/T ≥ 5), Fluid Cognition Composite (SS ≥ 12/T ≥ 9), Crystallized Cognition Composite (SS ≥ 6/T ≥ 5), and Total Cognition Composite (SS ≥ 8/T ≥ 7). These cutoffs are one of few resources to interpret cognitive change at retest among Spanish-speaking patients and participants.

Using supplemental memory measures to refine interpretation of the repeatable battery for the assessment of neuropsychological status

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is frequently used as a cognitive screening measure or as part of a comprehensive neuropsychological battery. Augmenting the current memory subtests of the RBANS to reflect clinically meaningful distinctions in memory performance may improve its clinical utility, allowing users to generate additional hypotheses and refine clinical interpretations. We pilot four supplementary memory measures to use with the RBANS, adapted from paradigms commonly used by other neuropsychological tests. We also provide several new theoretically derived memory indices to supplement the standard Delayed Memory Index. The new subtests correlated significantly with the standard memory measures, and the new indices demonstrated good reliability and diagnostic accuracy. This study provides preliminary support for supplementing the RBANS to allow for more nuanced interpretations of memory performance.

Mayo normative studies: regression-based normative data for ages 30-91 years with a focus on the Boston Naming Test, Trail Making Test and Category Fluency

OBJECTIVE

Normative neuropsychological data are essential for interpretation of test performance in the context of demographic factors. The Mayo Normative Studies (MNS) aim to provide updated normative data for neuropsychological measures administered in the Mayo Clinic Study of Aging (MCSA), a population-based study of aging that randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. We examined demographic effects on neuropsychological measures and validated the regression-based norms in comparison to existing normative data developed in a similar sample.

METHOD

The MNS includes cognitively unimpaired adults ≥30 years of age (n = 4,428) participating in the MCSA. Multivariable linear regressions were used to determine demographic effects on test performance. Regression-based normative formulas were developed by first converting raw scores to normalized scaled scores and then regressing on age, age2, sex, and education. Total and sex-stratified base rates of low scores (T < 40) were examined in an older adult validation sample and compared with Mayo's Older Americans Normative Studies (MOANS) norms.

RESULTS

Independent linear regressions revealed variable patterns of linear and/or quadratic effects of age (r2 = 6-27% variance explained), sex (0-13%), and education (2-10%) across measures. MNS norms improved base rates of low performance in the older adult validation sample overall and in sex-specific patterns relative to MOANS.

CONCLUSIONS

Our results demonstrate the need for updated norms that consider complex demographic associations on test performance and that specifically exclude participants with mild cognitive impairment from the normative sample.

The Relationship Between Apathy and Cognitive Impairment Among Hispanic/Latin Americans: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses Systematic Review

OBJECTIVES

The primary aim was to evaluate apathy assessment measures in relation to cognitive impairment among Hispanic/Latin Americans.

METHODS

A systematic review on the relationship between apathy and cognitive impairment among Hispanic/Latin Americans across normal aging and neurocognitive disorders was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and using APA PsycInfo, Embase, and PubMed databases. Inclusion criteria required (1) a sample of English or Spanish-speaking adults ages 18 years and older, (2) with measures of apathy, (3) assessment of cognitive functioning or diagnosis of neurocognitive disorder, (4) with at least 18.5% Hispanic/Latin American represented in the sample.

RESULTS

Only 14 papers met criteria to be included in this review. Of the 12 cross-sectional studies, 9 demonstrated significant associations between increased apathy and cognitive impairment, 1 demonstrated a descriptive difference between apathy and cognitive status (ie, no hypothesis test conducted), while 2 demonstrated null effects. These cross-sectional studies consisted of community and clinic samples of participants across North and South America. Two longitudinal studies conducted in North America demonstrated non-significant associations of apathy with cognitive status.

CONCLUSIONS

The Neuropsychiatric Inventory (NPI) and Neuropsychiatric Inventory Questionnaire (NPI-Q) apathy subscales were the most used measures for apathy in this review (85.7% of included studies). However, validity evidence from a review of apathy measures has warranted caution against the use of the NPI outside the context of screening for apathy. This potential measurement bias with Hispanic/Latin Americans apathy research limits conclusions drawn from the present review.

Psychometric properties of the Arabic version of the everyday memory questionnaire - revised (EMQ-R) among the Lebanese population

Objective: This study aimed to evaluate the psychometric properties of the Arabic version of the Everyday Memory Questionnaire- Revised (EMQ-R-A) in a sample of Lebanese adults. Methods: A cross-sectional study was conducted in August 2023. A diverse sample of 483 Lebanese adults aged 18 to 60 years from all Lebanese governorates was recruited. Participants completed an Arabic-language questionnaire comprising three sections: socio-demographic characteristics, health-related inquiries, the EMQ-R-A and the Arabic version of the Prospective and Retrospective Memory Questionnaire (PRMQ). Results: The study's findings indicated that the EMQ-R-A displayed strong internal consistency (Cronbach's alpha = 0.925). Convergent validity was supported by a significant correlation with PRMQ. Test-retest results demonstrated strong reliability with a Cronbach's alpha of 0.925. Confirmatory factor analysis revealed a three-factor model including retrieval related factors, attentional tracking related factors, and other factors. The factors labeled "Retrieval" and "Attentional Tracking" elucidate aspects of memory retrieval system efficacy and attention-related challenges. Higher EMQ-R-A scores were found to be associated with the female gender, lower attention, physical inactivity, lower educational levels, and higher number of comorbid disorders. Conclusion: The EMQ-R-A exhibits good validity and reliability. The identified factors associated with memory decline underscore the importance of addressing lifestyle factors, such as promoting physical activity, better educational attainment, and addressing comorbid health conditions, to potentially mitigate memory challenges.

Psychometrics of inertial heading perception

BACKGROUND

Inertial self-motion perception is thought to depend primarily on otolith cues. Recent evidence demonstrated that vestibular perceptual thresholds (including inertial heading) are adaptable, suggesting novel clinical approaches for treating perceptual impairments resulting from vestibular disease.

OBJECTIVE

Little is known about the psychometric properties of perceptual estimates of inertial heading like test-retest reliability. Here we investigate the psychometric properties of a passive inertial heading perceptual test.

METHODS

Forty-seven healthy subjects participated across two visits, performing in an inertial heading discrimination task. The point of subjective equality (PSE) and thresholds for heading discrimination were identified for the same day and across day tests. Paired t-tests determined if the PSE or thresholds significantly changed and a mixed interclass correlation coefficient (ICC) model examined test-retest reliability. Minimum detectable change (MDC) was calculated for PSE and threshold for heading discrimination.

RESULTS

Within a testing session, the heading discrimination PSE score test-retest reliability was good (ICC = 0. 80) and did not change (t(1,36) = -1.23, p = 0.23). Heading discrimination thresholds were moderately reliable (ICC = 0.67) and also stable (t(1,36) = 0.10, p = 0.92). Across testing sessions, heading direction PSE scores were moderately correlated (ICC = 0.59) and stable (t(1,46) = -0.44, p = 0.66). Heading direction thresholds had poor reliability (ICC = 0.03) and were significantly smaller at the second visit (t(1,46) = 2.8, p = 0.008). MDC for heading direction PSE ranged from 6-9 degrees across tests.

CONCLUSION

The current results indicate moderate reliability for heading perception PSE and provide clinical context for interpreting change in inertial vestibular self-motion perception over time or after an intervention.

Psychometric Properties of the Healthy Lifestyle Behaviors Scale in Portuguese Pregnant Women

BACKGROUND

Pregnancy provides a privileged and opportune moment to implement interventions promoting healthy lifestyle behaviors and significantly improving perinatal outcomes. The Healthy Lifestyle Behaviors Scale (HLBES) can be used to assess health promoting behaviors, such as diet, physical activity, and mental health.

PURPOSE

This study aimed to examine the psychometric properties of the HLBES in Portuguese pregnant women.

METHODS

A methodological study was conducted on a convenience sample of 192 pregnant women receiving prenatal care. After cross-cultural adaptation, an exploratory factor analysis and internal consistency assessment were carried out to evaluate the psychometric properties of the scale. Data collected included the Healthy Lifestyle Beliefs Scale to assess the HLBES' criterion validity.

RESULTS

Exploratory factor analysis with Varimax rotation yielded 2 subscales that explained 45.23% of the total variance. The scale revealed an overall internal consistency of 0.78 and a good criterion validity with the Healthy Lifestyle Beliefs Scale (r = 0.65, P < .01).

CONCLUSION

Our results suggest that the HLBES is an instrument for reporting healthy lifestyle behaviors in Portuguese pregnant women; however, further studies are recommended. This scale can be used to not only describe healthy lifestyle behaviors in pregnant women but also to determine the effects of health promoting interventions.

Vision-related quality of life in children: Cross-cultural adaptation and test-retest reliability of the Danish version of the paediatric refractive error profile 2

PURPOSE

To translate and cross-culturally adapt PREP2 into Danish and to investigate the face validity and reliability of Danish PREP2 through cognitive interviewing, Rasch and reliability analyses.

METHODS

The Danish PREP2 was translated using a standardized procedure and then pretested following the Three-Steps-Interviews (TSTI) process. A total of 15 myopic children aged 7-14 wearing either orthokeratology lenses (ortho-k) or single-vision spectacles (SVS) were included in pretesting comprising cognitive interviews and Rasch analysis. Data from cognitive interviewing was analysed thematically according to Collins. Rasch analysis was used to pretest the psychometric properties in terms of person- and item-fit statistics. Reliability was assessed via test-retest using Intra-class correlation coefficient (ICC) in the CONTROL study population, which consisted of 60 Danish children aged 7-14 years wearing either ortho-k or SVS.

RESULTS

Fifteen children participated in pilot studies comprising of cognitive interviewing and Rasch analysis and 44 out of 60 CONTROL children participated in test-retest reliability analysis. The translation process resulted in a Danish version of PREP2 corroborating the original. Pretesting highlighted issues in the contextualization of items and in marking responses. Thus, we introduced a digital format with help texts. Cognitive interviewing identified issues in the following Collins' themes: comprehension (understanding of concepts), judgement (ambiguity of items) and response (selecting answers). Rasch analysis indicated that help texts were useful for clarifying context. The ICC was 0.77 (95% CI: 0.66-0.85).

CONCLUSIONS

The cross-cultural adaptation of PREP2 was satisfactory and issues were identified and corrected through pretesting. The test-retest reliability showed substantial consistency. The instrument could be validated in a more generalizable setting in future studies.

TRIAL REGISTRATION

NCT03246464 (CONTROL study).

Ultrasound measurement of traumatic scar and skin thickness: a scoping review of evidence across the translational pipeline of research-to-practice

OBJECTIVES

To identify the ultrasound methods used in the literature to measure traumatic scar thickness, and map gaps in the translation of these methods using evidence across the research-to-practice pipeline.

DESIGN

Scoping review.

DATA SOURCES

Electronic database searches of Ovid MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature and Web of Science. Grey literature searches were conducted in Google. Searches were conducted from inception (date last searched 27 May 2022).

DATA EXTRACTION

Records using brightness mode (B-mode) ultrasound to measure scar and skin thickness across the research-to-practice pipeline of evidence were included. Data were extracted from included records pertaining to: methods used; reliability and measurement error; clinical, health service, implementation and feasibility outcomes; factors influencing measurement methods; strengths and limitations; and use of measurement guidelines and/or frameworks.

RESULTS

Of the 9309 records identified, 118 were analysed (n=82 articles, n=36 abstracts) encompassing 5213 participants. Reporting of methods used was poor. B-mode, including high-frequency (ie, >20 MHz) ultrasound was the most common type of ultrasound used (n=72 records; 61% of records), and measurement of the combined epidermal and dermal thickness (n=28; 24%) was more commonly measured than the epidermis or dermis alone (n=7, 6%). Reliability of ultrasound measurement was poorly reported (n=14; 12%). The scar characteristics most commonly reported to be measured were epidermal oedema, dermal fibrosis and hair follicle density. Most records analysed (n=115; 97%) pertained to the early stages of the research-to-practice pipeline, as part of research initiatives.

CONCLUSIONS

The lack of evaluation of measurement initiatives in routine clinical practice was identified as an evidence gap. Diverse methods used in the literature identified the need for greater standardisation of ultrasound thickness measurements. Findings have been used to develop nine methodological considerations for practitioners to guide methods and reporting.

Testing the psychometric properties of 9 bolt-ons for the EQ-5D-5L in a general population sample

OBJECTIVES

We aim to assess the psychometric performance and added value of nine existing bolt-ons (breathing problems, cognition, hearing, self-confidence, skin irritation, sleep, social relationships, tiredness and vision) for the EQ-5D-5L in a general population sample.

METHODS

The EQ-5D-5L, nine bolt-ons, SF-6Dv1, PROMIS-29+2, PROMIS Global Health and Satisfaction With Life Scale were completed in an online cross-sectional survey among a general adult population sample in Hungary (n=1587). The following psychometric properties were tested for the EQ-5D-5L+bolt-on(s): ceiling, divergent and convergent validity, structural validity, known-group validity and explanatory power.

RESULTS

Adding sleep (30%), tiredness (24%) or vision (21%) substantially reduced the ceiling of the EQ-5D-5L (41%). Cognition, sleep, social relationships and tiredness correlated with corresponding PROMIS and SF-6D items (rs=ǀ0.32ǀ-ǀ0.73ǀ). All bolt-ons, except cognition and self-confidence, loaded on a different factor from the EQ-5D-5L dimensions. Breathing, hearing, skin irritation and vision significantly improved known-group validity in relevant health condition groups. The sleep bolt-on improved known-group validity in 9 out of 13 chronic health conditions. Tiredness had the largest impact on explaining EQ VAS score variance in 8 out of 13 conditions. Hearing and vision improved the ability of the EQ-5D-5L to capture declining health with age, while self-confidence and social relationships were valuable for mental health assessment.

CONCLUSIONS

This study established the validity of multiple bolt-ons for the EQ-5D-5L and highlights the usefulness of including relevant bolt-ons in population-based and patient surveys. Our findings inform the further development of these bolt-ons and the bolt-on item selection for clinical studies.

Psychometric Characteristics of the Chinese Version of the Tuberculosis Related-Stigma Scale in a Population of Medical Students and Its Correlation with Selected Demographic Characteristics

Background

As future health workers, medical students' attitudes towards tuberculosis (TB) patients can impact TB control. However, in China, there is a lack of well-quantified assessment regarding the stigma among medical students towards TB patients. Therefore, this study aimed to validate the Chinese version of the Tuberculosis related-Stigma Scale (TSS) in medical students and to apply the scale to measure stigma and its determinants.

Methods

A total of 1035 eligible medical students participated in the cross-sectional questionnaire. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were first conducted to test Chinese version of the TSS construct validity, and then internal consistency was assessed using Cronbach's α. Finally, multiple linear regression analyses were conducted to identify predictors of stigma.

Results

EFA extracted two factors ("Social distance" and "Exclusionary sentiments"). The CFA further confirmed the two-factor construct. The internal consistency, convergent and divergent validity of the adapted Chinese version of the TSS was acceptable. Furthermore, Whether one has received TB health education and whether know a person with TB are associated with all dimensions of TB stigma, while differences in sex and place of residence play different roles in influencing the different dimensions of stigma.

Conclusion

The adapted Chinese version of the TSS can be used to assess the level of stigma among medical students in China towards tuberculosis patients. When implementing future interventions to reduce stigma associated with TB, special attention should be given to medical students from urban areas, of male gender, who have not received TB health education, and no know a person with TB. However, these two dimensions ("Social distance" and "Exclusionary sentiments") are impacted by different determinants and should therefore be addressed separately when designing, implementing, and evaluating measures to reduce stigma.

The Turkish version of nursing practice readiness scale: Cross-cultural adaptation and psychometric evaluation

AIM

This study aims to adapt the "Nursing Practice Readiness Scale" to Turkish culture, and evaluate its psychometric properties.

BACKGROUND

New graduates' nursing practice readiness can impact their work adaptation and performance.

DESIGN

The research employed a methodological design.

METHODS

Data were collected between May and July 2022. The sample consisted of 436 newly graduated nurses. Content validity, construct validity and criterion validity were evaluated. Reliability was examined with adjusted item-total correlation, Cronbach's a coefficient, composite-reliability and split-half reliability.

RESULTS

The Turkish version of Nursing Practice Readiness Scale was found to have good content and criterion validity. As a result of confirmatory factor analysis, the original five-factor structure of the scale was also confirmed for the Turkish version. The scale's overall Cronbach's α coefficient was determined to be 0.96, with subscale coefficients ranging from 0.73 to 0.94. The composite reliability values of the subscales were found between 0.75 and 0.94. In split-half reliability, the correlation coefficient between half was 0.952, with a Spearman-Brown Coefficient (Unequal Length) of 0.976.

CONCLUSIONS

The Turkish version of Nursing Practice Readiness Scale is a valid and reliable measurement tool for evaluating the nursing practice readiness of newly graduated nurses.

Psychometric testing of the Thai version of Caregiver Contribution to Self-Care of Chronic Illness Inventory version 2

AIM

To assess the psychometric properties of the Thai version of Caregiver Contribution to Self-Care of Chronic Illness Inventory version 2 (CC-SC-CII-v2) among primary caregivers of individuals with any single or multiple chronic illnesses.

BACKGROUND

The instrument encompasses three scales that evaluate Caregiver Contribution to Self-Care (CC-SC) Maintenance, Monitoring and Management.

METHODS

The English version CC-SC-CII-v2 was translated and adapted for Thai context, and a cross-sectional multicenter study involved 430 caregivers from 16 primary care centres in Thailand. Structural validity, internal consistency reliability and test-retest reliability were examined.

RESULTS

The original two-factor CC-SC Maintenance scale required a re-specified model for good fit, while the CC-SC Monitoring and CC-SC Management scales fit well. The simultaneous model of three scales demonstrated satisfactory fit. The CC-SC Maintenance and CC-SC Management scales both had a composite reliability index of 0.85, with omega coefficients of 0.86 and 0.83, respectively. CC-SC Monitoring had an alpha coefficient of 0.89. The intraclass correlation coefficients ranging from 0.84 to 0.91, indicating good test-retest reliability.

CONCLUSION

The Thai CC-SC-CII-v2 is a valid and reliable instrument that can provide clinicians and investigators with an evaluation of the contributions of caregivers to the self-care of patients with chronic illnesses.

Psychometrically validated questionnaires to measure the effects and benefits/barriers to physical exercise in hemodialysis patients: a systematic review

PURPOSE

To provide a critical assessment, summarize, and synthesize the evidence from studies using psychometrically validated questionnaires to assess the effects and benefits/barriers of physical exercise in hemodialysis patients.

METHODS

The search was performed on six electronic databases. It was conducted following the PRISMA statement and the PICO framework. The methodological quality was assessed using the MMAT. Were used the quality criteria for psychometric properties developed by Terwee et al.

RESULTS

Overall, 70 studies were included, and 39 questionnaires identified, evaluating 13 outcomes. The quality of the psychometric properties of the questionnaires was not always described; only 13 presented positive ratings on > =6/9 properties. The most assessed measure was criterion validity, and the least assessed criteria was responsiveness. The most outcome measured by these questionnaires was quality of life using SF-36, followed by psychological health using the BDI. The DPEBBS was the only instrument identified that assessed the benefits and barriers of exercise.

CONCLUSION

Quality of life and depression were the most frequent outcomes. Other measures contemplating physical, mental, cognitive performance, and especially of the perceptions benefits and barriers to exercise should be further investigated. We have clearly identified the need for more studies evaluating psychometric measures that have not been tested satisfactorily or hardly been tested at all.

A Psychometric Evaluation of the Expanded Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) in Children and Adolescents

The expanded version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) is a self-report measure of 18 empirically derived internalizing symptom dimensions. The measure has shown good psychometric properties in adults but has never been evaluated in children and adolescents. A Swedish version of the IDAS-II was administered to 633 children and adolescents (Mage =16.6 [SD = 2.0]) and 203 adults (Mage = 35.4 [SD = 12.1]). The model/data fit of the 18-factor structure was excellent in both samples and measurement invariance across age groups was supported. All scales showed good to excellent internal consistency and psychometric properties replicated in the younger youth sample (< 16 years). Among youth, good convergent validity was established for all scales and divergent validity for most scales. The IDAS-II was better at identifying youth with current mental health problems than an internationally recommended scale of internalizing symptoms. In conclusion, the IDAS-II shows promise as a measure of internalizing symptoms in youth.

Development and Validation of a Broad and Fear-Adaptable Measure of Fear Approach and Application to Common Eating Disorder Fears

Fear approach is a theorized mechanism of exposure treatment for anxiety-based disorders. However, there are no empirically established self-report instruments measuring the tendency to approach feared stimuli. Because clinical fears are heterogeneous, it is important to create a measure that is adaptable to person- or disorder-specific fears. The current study (N = 455) tests the development, factor structure, and psychometric properties of a self-report instrument of fear approach broadly and the adaptability of this measure to specific eating disorder fears (i.e., food, weight gain). Factor analyses identified a unidimensional, nine-item factor structure as the best fitting model. This measure had good convergent, divergent, and incremental validity and good internal consistency. The eating disorder adaptations retained good fit and strong psychometric properties. These results suggest that this measure is a valid, reliable, and adaptable measure of fear approach, which can be used in research and exposure therapy treatment for anxiety-based disorders.

Validity and Reliability of Handheld Dynamometry to Assess Isometric Hamstrings and Quadriceps Strength at Varying Muscle Lengths

CONTEXT

The hamstrings are the most commonly injured muscle in sports and are especially injury prone in lengthened positions. Measuring knee muscle strength in such positions could be relevant to establish injury risk. Handheld dynamometry has been shown to be a valid, reliable, and practical tool to measure isometric muscle strength clinically. The aim of this study was to assess the validity and reliability of the assessment of isometric knee muscle strength with a handheld dynamometer (HHD) at various muscle lengths, by modifying the hip and knee angles during testing.

DESIGN

Concurrent validity and test-retest reliability.

METHODS

Thirty young healthy participants were recruited. Hamstring and quadriceps isometric strength was measured with a HHD and with an isokinetic dynamometer, over 2 testing sessions, in a randomized order. Isometric strength was measured on the right lower limb in 6 different positions, with the hip at either 0° or 80° of flexion and the knee at either 30°, 60°, or 90° of flexion. Pearson and Spearman correlations were used to assess the validity, and intraclass correlation coefficients were calculated to establish the test-retest reliability of the HHD.

RESULTS

Good to excellent reliability and moderate to high validity were found in all the tested muscle length positions, except for the hamstrings in a seated position with the knee extended at 30°.

CONCLUSIONS

The use of a HHD is supported in the clinical setting to measure knee muscle strength at varying muscle lengths in healthy adults, but not for the hamstrings in a lengthened position (hip flexed and knee extended). These results will have to be confirmed in sport-specific populations.

Complementing the United States Household Food Security Survey Module with Items Reflecting Social Unacceptability

BACKGROUND

Social unacceptability of food access is part of the lived experience of food insecurity but is not assessed as part of the United States Household Food Security Survey Module (HFSSM).

OBJECTIVES

The objectives were as follows: 1) to determine the psychometric properties of 2 additional items on social unacceptability in relation to the HFSSM items and 2) to test whether these 2 items provided added predictive accuracy to that of the HFSSM items for mental health outcomes.

METHODS

Cross-sectional data used were from the Intersection of Material-Need Insecurities and HIV and Cardiovascular Health substudy of the Multicenter AIDS Cohort Study/Women's Interagency HIV Study Combined Cohort Study. Data on the 10-item HFSSM and 2 new items reflecting social unacceptability were collected between Fall 2020 and Fall 2021 from 1342 participants from 10 United States cities. The 2 social unacceptability items were examined psychometrically in relation to the HFSSM-10 items using models from item response theory. Linear and logistic regression was used to examine prediction of mental health measured by the 20-item Center for Epidemiologic Studies Depression scale and the 10-item Perceived Stress Scale.

RESULTS

The social unacceptability items were affirmed throughout the range of severity of food insecurity but with increasing frequency at higher severity of food insecurity. From item response theory models, the subconstructs reflected in the HFSSM-10 and the subconstruct of social unacceptability were distinct, not falling into one dimension. Regression models confirmed that social unacceptability was distinct from the subconstructs reflected in the HFSSM-10. The social unacceptability items as a separate scale explained more (∼1%) variation in mental health than when combined with the HFSSM-10 items in a single scale, and the social unacceptability subconstruct explained more (∼1%) variation in mental health not explained by the HFSSM-10.

CONCLUSIONS

Two social unacceptability items used as a separate scale along with the HFSSM-10 predicted mental health more accurately than did the HFSSM-10 alone.

Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS

AIM

To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS).

METHODS

The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences.

RESULTS

Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR-P criteria. The semi-structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS.

CONCLUSIONS

Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses.

Psychometric Support for a Brazilian Version of the Multidimensional Assessment of Teamwork in Sport (MATS-B)

In this study, we investigated psychometric support for a version of the Multidimensional Assessment of Teamwork in Sport (MATS) that would be suitable for Brazilian athletes. Four translators participated in the back-translation of this instrument from English to Portuguese, two specialists synthesized the Portuguese and English back-translation versions, and 10 experts assessed the questionnaire items and judged their content validity. To evaluate structural validity, we performed confirmatory factor analysis (CFA). We evaluated internal item reliability with a sample of 447 athletes who completed the adapted measure (the MATS-B). Finally, 202 other athletes completed both the MATS-B and a second measure of collective efficacy (CEQS-B) to provide external validity correlates. With these data, the MATS-B now provides valid and reliable data supporting its use with Brazilian athletes in an adapted assessment tool that aligns with the conceptual framework of teamwork in sports.

Psychometric evaluation of the Trust in Science and Scientists Scale

Reliable and valid measurement of trust in science and scientists is important. Assessing levels of such trust is important in determining attitudes and predicting behaviours in response to medical and scientific interventions targeted at managing public crises. However, trust is a complex phenomenon that has to be understood in relation to both distrust and mistrust. The Trust in Science and Scientists Scale has been adopted with increasing frequency in large-scale public health research. Detailed psychometric evaluation of the scale is overdue and makes meaningful comparisons between studies that use the scale difficult. Here, we examine the scale's dimensionality across five separate samples. We find that two factors emerge that are divided by their item polarity. Implications for scale use and trust in science measurement are discussed.

Creating the Global Criminal Justice Survey: A Questionnaire Designed to Gather Perspectives from the Autism Community and Criminal Justice Professionals

Autistic people's perceptions of their interactions with criminal justice professionals are predominantly negative; however, little is known about the state of interactions on a global scale. To further understanding, a comprehensive stakeholder questionnaire was created. Aspects of reliability and validity including evidence for test content and internal structure were gathered using expert reviews, cognitive interviewing, pilot data collection, and a larger data collection effort (N = 1618). Data was gathered from the autism community through perspectives of parents/caregivers as well as from self-reported autistic adults. Criminal justice professionals included law enforcement officers, corrections professionals, probation and parole officers, forensic psychologists and legal professionals. The scale development process was detailed in order to sufficiently document the initial psychometric evidence and share the steps taken to gain diverse stakeholder input. This study is a critical first step in generating further information to facilitate policy and program development with wide applicability.

A proof-of-concept study testing the factor structure of the Stop Signal Task: overlap with substance use and mental health symptoms

Background: Research utilizing experimental tasks usually does not report estimates of internal reliability of measurement. However, modern measurement theories conceptualize reliability as sample dependent indicating that reliability should be empirically demonstrated in the samples used to make inferences.Objectives: Test whether confirmatory factor analytic (CFA) estimates of reliability can be applied to a commonly used task measuring response inhibition (the Stop Signal Task) to predict substance use (alcohol and cannabis) and mental health symptoms.Methods: Thirty-seven participants between the ages of 18-20 (72% female; 16% Asian, 3% Native American, 11% Black or African American, 59% White; 32% Latino/a/x) were recruited via social media advertisement and attended a laboratory visit. The Stop Signal Reaction Time (SSRT) was calculated as the outcome for three experimental blocks and used as indicators in a CFA.Results: CFA suggests the task yields reliable scores; factor loadings were statistically significant (p < .05) and substantial (standardized loadings ranged from .74 to .94). However, reliability increased across experimental blocks and error was non-trivial (ranging from 50% to 12% of the variance). The inhibition factor predicted higher maximum number of drinks consumed (β = .37, p < .05), higher frequency of cannabis use (β = .39, p < .05), and more cannabis use occasions within using days (β = .40, p < .05), as well as facets of mental health (anxious/depression, attention, and anxiety problems; all p's < .05).Conclusion: Results support the utility of CFA to test for reliability of measurement, with the ability to inhibit dominant responses serving as a transdiagnostic correlate of substance use and mental health problems.

Reliability and validity of the Montreal Cognitive Assessment's auditory items (MoCA-22)

Objective: To evaluate the latent structure, internal consistency, convergent and discriminant validity, diagnostic accuracy, and criterion validity of the Montreal Cognitive Assessment's auditory items (MoCA-22), which has previously been evaluated in small samples if at all. Methods: 11,284 participants completed the MoCA over 1-2 visits to an Alzheimer Disease Research Center (Mage = 69.2, Meducation = 15.9, 57.6% women, 92.4% non-Hispanic white). MoCA-22 items were probed with alpha, omega, confirmatory factor analysis, and test-retest correlations. Scores were related to measures of neurocognition, daily functioning, behavioral-psychological symptoms (BPS), and vision performance for convergent-discriminant and criterion validity. Dementia stage was used to calculate area under the receiver operating characteristic (AUC-ROC) curves and cutoffs for mild cognitive impairment (MCI) and dementia. Results: A single-factor had good fit (CFI = .961; TLI = .945; RMSEA = .061; SRMR = .031), with good internal consistency (Omega total = .83) and test-retest consistency (ICC = .92 at 2.7 years). The strongest convergent correlations were with general cognition and executive functioning, while discriminant validity was demonstrated with its weakest and negative correlations being with BPS. There was strong classification accuracy in distinguishing MCI from normal cognition (AUC = .79; optimal cutoff point < 18), and mild-to-moderate dementia from MCI (AUC = .85; optimal cutoff point < 13). Furthermore, the MoCA-22 had negligible-to-small differences among those with and without vision limitations. Conclusions: These findings add to the evidence of the MoCA-22's utility and it serves as a useful cognitive screening tool with sound reliability and validity.

Screening for Palliative Care Need in Oncology: Validation of Patient-Reported Outcome Measures

CONTEXT

Leading oncology societies recommend monitoring symptoms and support needs through patient-reported outcome measures (PROMs), but their use for assessing specialist palliative care (SPC) need has not yet been explored. Research on SPC integration has focused on staff-assessed screening tools, which are time-consuming.

OBJECTIVES

This study aimed to assess the diagnostic validity of the Integrated Palliative Outcome Scale (IPOS) and NCCN Distress Thermometer (NCCN DT) in identifying need for SPC in patients with incurable cancer.

METHODS

In a cross-sectional study, patients with incurable cancer (prognosis <2 years) completed PROMs. In an independent process, the palliative care consultation service (PCCS) assessed the need for SPC in each patient through multiprofessional case review, and this was used as the reference standard. ROC analyses were employed to determine diagnostic validity.

RESULTS

Of the 208 participants, 71 (34.1 %) were classified as having SPC need by the PCCS. Aiming for a minimum sensitivity of 80%, a cut-off of ≥2 items with high/very high burden in the IPOS resulted in a 90.2% sensitivity (specificity = 50; AUC = 0.791; CI 95%= 0.724-0.858). A cut-off of ≥5 resulted in a sensitivity of 80 % for NCCN DT (specificity = 49.5 %; AUC = 0.687; CI 95% = 0.596-0.777).

CONCLUSION

PROMs are useful for identifying SPC need in cancer patients. Their implementation might facilitate timely integration of SPC. Future research should focus on an integrated assessment approach with PROMs that combines the requirements of the different specialties to save patient and staff resources.

Looking for a broader mindset in psychometrics: the case for more participatory measurement practices

Psychometrics and the consequences of its use as the method of quantitative empirical psychology has been continuously criticized by both psychologists and psychometrists. However, the scope of the possible solutions to these issues has been mostly focused on the establishment of methodological-statistical best practices for researchers, without any regard to the pitfalls of previous stages of measurement as well as theory development of the targeted phenomenon. Conversely, other researchers advance the idea that, since psychometrics is riddled with many issues, the best way forward is a complete rework of the discipline even if it leaves psychologists and other practitioners without any way to measure quantitatively for a long period of time. Given these tensions, we therefore advocate for an alternative path to consider while we work on making substantive change in measurement. We propose a set of research practices focusing on the inclusion and active participation of groups involved in measurement activities, such as psychometrists, researchers but most importantly practitioners and potential participants. Involving a wider community while measuring in psychology could tackle some key issues that would take us closer to a more authentic approach to our phenomenon of interest.

Psychometric evaluation and linking of the PHQ-9, QIDS-C, and VQIDS-C in a real-world population with major depressive disorder

Purpose

Major depressive disorder (MDD) is a leading cause of disability worldwide. An accurate assessment of depressive symptomology is crucial for clinical management and research. This study assessed the convergent validity, reliability, and total scale score interconversion across the 9-item Patient Health Questionnaire (PHQ-9) self-report, the 16-item Quick Inventory of Depressive Symptomatology-clinician report (QIDS-C) (two widely used clinical ratings) and the 5-item Very Brief Quick Inventory of Depressive Symptoms-clinician report (VQIDS-C), which evaluate the core features of MDD.

Patients and Methods

This study leveraged electronic health record (EHR)-derived, de-identified data from the NeuroBlu Database (Version 23R1), a longitudinal behavioural health real-world platform. Classical Test Theory (CTT) and Item Response Theory (IRT) analyses were used to evaluate the reliability, validity of, and conversions between the scales. The Test Information Function (TIF) was calculated for each scale, with greater test information reflecting higher precision and reliability in measuring depressive symptomology. IRT was also used to generate conversion tables so that total scores on each scale could be compared to the other.

Results

The study sample (n = 2,156) had an average age of 36.4 years (standard deviation [SD] = 13.0) and 59.7% were female. The mean depression scores for the PHQ-9, QIDS-C, and VQIDS-C were 12.9 (SD = 6.6), 12.0 (SD = 4.9), and 6.18 (SD = 3.2), respectively. The Cronbach's alpha coefficients for PHQ-9, QIDS-C, and VQIDS-C were 0.9, 0.8, and 0.7, respectively, suggesting acceptable internal consistency. PHQ-9 (TIF = 30.3) demonstrated the best assessment of depressive symptomology, followed by QIDS-C (TIF = 25.8) and VQIDS-C (TIF = 17.7).

Conclusion

Overall, PHQ-9, QIDS-C, and VQIDS-C appear to be reliable and convertible measures of MDD symptomology within a US-based adult population in a real-world clinical setting.

Psychometric Testing of the Experience of Integrating Chronic Illness into Family Life Questionnaire

Family members' experience of integrating chronic illnesses or chronic conditions into family life is valuable information for health care professionals, such as nurses, to understand, improve, and adjust the care provided to families of chronically ill patients. Furthermore, the assessment of the experience of integrating chronic illness into family life can support family nursing interventions and reduce suffering. This study aimed to adapt and psychometrically test a new Likert-type questionnaire on the experience of integrating pediatric chronic illness into family life (EICI-FLQ) in two European samples. A sample of 164 primary caregivers of children/adolescents with chronic illnesses/conditions in Iceland and another sample of 237 primary caregivers with children/adolescents with chronic illnesses/conditions in Portugal completed the online questionnaire. Exploratory factor analysis of the Icelandic sample yielded support for a one-factor solution with acceptable internal reliability (Cronbach's α = .866). Confirmatory factor analysis of the one-factor structure in the Portuguese sample indicated good model fit and similar internal reliability (Cronbach's α = .838). This instrument has good psychometric characteristics and is a promising tool for measuring the experience of integrating pediatric chronic illness into family life in clinical and research settings.

Beyond Men's Experiences: Scale Development and Psychometric Testing of the Fitness in Nursing Scale-Men (FiNS-M)

Background and Purpose: Men believe they are perceived as unfit for nursing. No scales exist to measure perceptions of men's fitness for nursing. Additionally, women have been largely excluded from this area of inquiry. This study's purpose was to develop and test the psychometric properties of the Fitness in Nursing Scale for Men. Methods: Six hundred thirty-five nurses participated. Scale development entailed concept clarification, item development, and scale testing. Results: Confirmatory factor analysis suggested a two-factor structure (F1: nursing fitness and F2: strengths of men in nursing) which demonstrated good model fit, root mean square error of approximation = .059, 90% CI (.056, .063), standardized root mean square residual = .055, comparative fit index = .932, Tucker-Lewis index = .927, and ωt = .98. Invariance held. Latent means were not significantly different for women (M = 5.90) compared with men (M = 5.92). Conclusions: Findings suggest men are perceived as fit for nursing, but results are inconsistent with men's qualitative experiences. Future research should attempt to reconcile the disagreement. Findings can inform cultural awareness strategies in the workplace and classroom.

Cross-Cultural Adaptation of the Scale of the Nursing Work Index With Nurses From Seven Countries

Background and Purpose: The aims of this study are as follows: to adapt and validate the psychometric properties of the Spanish version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) adapted to the nursing home environment across seven Spanish-speaking countries and to cross-culturally adapt the Scale of the Nursing Work Index with nurses from seven countries. Methods: Adaptation process and psychometric validation of the instrument included translation and back-translation, content validity, test-retest reliability, internal consistency, and construct validity. Results: A total of 134 nursing homes belonging to the same religious order were randomly selected from seven Spanish-speaking countries with a sample of 378 nurses. The exploratory factor analysis explained a five-factor structure (56% of the explained variance) with adequate goodness-of-fit indices in the final factor solution. Conclusions: The validation process indicates that the Spanish language version of the PES-NWI with five factors and 31 items, for long-term care facilities for the elderly, is valid and reliable in its current version and can be used to measure the environment of nurses working in clinical practice in Spanish-speaking nursing homes.

Psychometric Evaluation of the Food Life Questionnaire-Short Form among Brazilian Adult Women

Measures of beliefs and attitudes toward food have generally been limited to the measurement of more pathological eating attitudes (e.g., disordered eating). The Food Life Questionnaire (FLQ) and its short form (FLQ-SF) were developed to examine attitudes toward a broader range of foods; however, the factor structure of the FLQ-SF was not confirmed in any study with young women. In the present study, we performed a psychometric evaluation of the Brazilian Portuguese translation of the FLQ-SF in a sample of 604 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach. Results supported a four-factor structure (i.e., weight concern, diet-health orientation, belief in a diet-health linkage, and food and pleasure) with 18 items (χ2/df = 2.09; CFI = 0.95; TLI = 0.94; RMSEA = 0.05 (90% CI = 0.04; 0.06; p > 0.05); and SRMR = 0.08). Additionally, we found good internal consistency for all FLQ-SF subscales (McDonald's ω = 0.79-0.89) and convergent validity with measures of feelings, beliefs, and behaviors involved in food attitudes. Collectively, these results support the use of the FLQ-SF in Brazilian women and provide a foundation to expand the literature on beliefs and attitudes toward food in this population.

Measuring depression and anxiety in autistic college students: A psychometric evaluation of the PHQ-9 and GAD-7

LAY ABSTRACT

Anxiety, depression, and suicidality are major concerns among college students, though less is known about these constructs in autistic college students. Given the rising number of autistic individuals entering college, adequate screening and diagnosis of mental health difficulties is necessary to provide care to this population. For example, despite widespread usage of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), it is unknown if the two instruments accurately measure depression and anxiety the same way between non-autistic and autistic individuals. Thus, the current study was the first to examine how these instruments measure depression and anxiety symptoms in autistic versus non-autistic college students. Utilizing tests of construct measurement in a sample of autistic (n = 477) and non-autistic (n = 429) university students aged 18-29, results showed that while the GAD-7 and PHQ-9 appear to be accurately capturing anxiety and depression in autistic college students, the PHQ-9 item assessing suicidality was found to be measuring different things. This indicates that autistic college students are not interpreting this question the way non-autistic students are, and thus, the measure is failing to capture suicidality in autistic people. Future investigators should continue to assess the appropriateness of using common screening measures, originally created by non-autistic people, in autistic populations.

A tool for assessing sexual knowledge of people with Intellectual disabilities in Norway

Background

Previous research has shown that people with intellectual disabilities have limited sexual knowledge, which can be essential for developing positive sexuality. This study aimed to check the validity and reliability of an assessment tool (SexKunn) for measuring the sexual knowledge of people with intellectual disabilities in Norway. Further, we aimed to identify potential knowledge gaps among the participants and highlight their potential impact.

Methods

37 people with intellectual disabilities completed one assessment. 20 participants then completed a retest. Clinicians' (n=23) views on the assessment tool were measured to obtain face validity. Positive and negative agreement analysis was used to identify potential dimensions in the data.

Results

A weighted Cohen's kappa for the test and retest of the overall scores was considered to be substantial. The clinicians described an acceptable face validity regarding high positive value scores and low negative burden scores. They also suggested improvements. The study identified that the participants lacked knowledge about female genitals, hygiene, appropriate touching/sexual acts with friends/intimate partners, and contraception.

Conclusions

The SexKunn is a feasible assessment tool to measure sexual knowledge in people with intellectual disabilities. A lack of sexual knowledge of people with intellectual disabilities may violate their sexual rights.

Assessing alexithymia: the proposal of a psychometric tool based on spheric videos

The present perspective introduces a novel psychometric tool designed to enhance the evaluation of alexithymia. Alexithymia, a condition marked by difficulties in recognizing and expressing emotions, along with a propensity to direct attention outside rather than toward one's own interior experiences, is commonly investigated through self-report questionnaires. These instruments assume that individuals have sufficient self-awareness and abstraction capabilities, which restricts the understanding of the underlying mechanisms of emotional recognition in individuals who do not possess these capacities. To address this lack, emerging technologies like virtual reality (VR) and 360° videos facilitate the recreation of immersive contexts, enabling subjects to engage with scenarios even remotely. Our innovative tool employs spherical video technology to recreate social and non-social scenarios that elicit emotions. Psychophysiological measures are collected during video observation; then, questions are asked to investigate how the subject consciously processes the emotions they experienced. This multimodal approach aims to capture both implicit and explicit emotion processing, providing a comprehensive assessment. Overall, the proposed psychometric tool offers the potential for a more nuanced understanding of alexithymic traits and their real-life impact, empowering clinicians to tailor treatment processes to individual needs based on a richer set of information.

Reliability testing of the Health of the Nation Outcome Scales 2018

WHAT IS KNOWN ON THE SUBJECT

The Health of the Nation Outcome Scales (HoNOS) is a widely used clinical measure designed to rate and monitor the outcomes of service users accessing specialist mental healthcare. Since its development (in 1996), numerous research studies have confirmed the HoNOS captures the aspects of care that it purports to (validity), and that clinicians' ratings are consistent both over time, and between different raters (reliability).

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

In 2018, the HoNOS was reviewed with updates made to some terminology and other revisions intended to remove ambiguity in the guidance for raters. However, although the new version (HoNOS 2018) was accompanied by a recommendation that its validity and reliability be re-tested this was not undertaken. To our knowledge, this is the first study to re-assess the updated tool's reliability by measuring the level of agreement between different raters. Our findings confirm that there is an acceptable level of consistency between student mental health nurses that have been trained to use the (new) HoNOS 2018.

WHAT ARE THE IMPLICATIONS FOR PRACTICE

The HoNOS is nationally mandated for use by all specialist mental healthcare providers in the UK. Our findings provide some assurance that, with appropriate update training and monitoring of organisational-level data sets, the original HoNOS glossary can safely be replaced with the HoNOS 2018 to ensure more contemporary routine outcome measurement can occur.

ABSTRACT

INTRODUCTION: The Health of the Nation Outcome Scales (HoNOS) is a well-established clinician rated outcome measure for use in mental health services. Following an international review, an updated version (HoNOS 2018) was published with a recommendation that its psychometric properties be re-tested prior to widespread implementation. To date, only one such study has been published.

AIMS

To test the inter-rater agreement levels for HoNOS 2018.

METHOD

Third-year student mental health nurses received training to complete the HoNOS 2018. Following this timetabled session, they were each invited to independently rate two, randomly selected, videos of (simulated) patient interviews. The resulting data were then analysed to calculate the tool's internal consistency and inter-rater agreement levels.

RESULTS

The 55 participants provided 106 ratings from four vignettes. Cronbach's alphas and McDonalds omegas confirmed the revised tool's internal consistency was acceptable. Average measure intraclass correlation coefficients for the four patient vignettes indicated excellent reliability.

IMPLICATIONS FOR PRACTICE

This study provides initial assurance that the HoNOS 2018 is a reliable clinician rated outcome measure suitable for use in routine clinical practice by relatively inexperienced mental health practitioners with limited training.

Cultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil

OBJECTIVES

to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil.

METHODS

psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω).

RESULTS

EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86.

CONCLUSIONS

the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.

Psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version

OBJECTIVE

to test the factorial structure, reliability and convergent validity of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version.

METHOD

this was a psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. Seven hundred and seventeen participants answered the data collection instrument consisting of two parts. Part I included a structured questionnaire to collect sociodemographic data and the participants' perceptions and satisfaction with their current health status. Part II consisted of the tool being tested. The internal structure was assessed using Confirmatory Factor Analysis. Convergent validity was evaluated by the correlation of the tool scores with the rates corresponding to self-perception and satisfaction with current health status. Reliability was assessed using Cronbach's alpha.

RESULTS

the Confirmatory Factor Analysis confirmed a three-factor solution. The factor loadings were significant and varied from 0.16 to 0.75; the fit indices suggested moderate fit of the model. Internal consistency for all three components varied between 0.779 and 0.919.

CONCLUSION

the findings suggest that the tool is valid and reliable to be used in the Brazilian population, although caution is recommended when interpreting the results due to the moderate fit of the model.

BACKGROUND

(1) The FHPAST-BR is a structured, valid and reliable Nursing-driven assessment tool.

BACKGROUND

(2) The tool provides a way of organizing clinical data and easing decision-making.

BACKGROUND

(3) The FHPAST-BR can be used in clinical practice and research.

Evolution of an Instrument: Measuring the Nursing Work Environment: A Scoping Review

Background and Purpose: The Nursing Work Index (NWI) was developed in the 1980s to measure the nursing work environment (NWE). Instruments descended from the NWI continue to measure the NWE today. The purpose of this review was to identify instruments derived from the NWI, examine how they have been used and revised, and evaluate their ability to capture elements of the current work environment. Methods: A scoping literature review. Results: Forty articles were included. Instruments developed from the NWI have been translated into numerous languages and administered to hundreds of thousands of nurses globally. Conclusions: The study of the NWE remains extensive throughout the world. Future research should examine the factorial structure of instrument adaptions and ensure that items are relevant to contemporary nursing practice.

The Measurement Properties of the EQ Health and Well-being and EQ Health and Well-Being Short Form in Italian Population: A Comparative Study With EQ-5D-5L

OBJECTIVES

The EQ Health and Well-being, EQ-HWB (25-item) and the EQ-HWB-S (9-item), are new generic measures of health and well-being. The purpose of this study was to examine the measurement properties of the EQ-HWB and EQ-HWB-S measures in relation to the EQ-5D-5L among the Italian general population.

METHODS

A cross-sectional survey was conducted from October 2020 to February 2021, followed by secondary analysis of collected data from Italian adults. This analysis included response pattern distributions, correlation strength, and known-group comparison. Known-group comparison was assessed using effect sizes (ES) across health conditions, caregiver status, and social care usage. The EQ-HWB-S index-based score was based on the UK pilot value set, whereas the Italian value set was used for scoring the EQ-5D-5L index.

RESULTS

Out of the 1182 participants, 461 reported having a chronic condition, 185 identified as caregivers, and 42 were social care users. EQ-HWB items (7.5%) showed fewer ceiling effects than EQ-5D-5L items (34.7%). Strong correlations (rs > 0.5) were found between overlapping EQ-HWB and EQ-5D-5L items. EQ-HWB-S and EQ-5D-5L index scores demonstrated similar discrimination based on symptomatic chronic conditions (ES d = 0.68 vs d = 0.71), but EQ-HWB-S had slightly higher ES for social care users (ES d = 0.84 vs d = 0.74).

CONCLUSIONS

Initial evidence supports the validity of EQ-HWB/EQ-HWB-S because outcome measures in the Italian population. EQ-HWB-S performed comparably to EQ-5D-5L among patients and was better in differentiating social care users. A slight decrease in discriminative properties for caregivers was observed when transitioning from EQ-HWB to EQ-HWB-S.

Sex-related differential item functioning of the Jenkins Sleep Scale: a cross-sectional study among 77 967 employees in the Finnish public sector

OBJECTIVES

To investigate if the Jenkins Sleep Scale (JSS) demonstrates sex-related differential item functioning (DIF).

DESIGN

Cross-sectional study.

SETTING

Survey data from the Finnish Public Sector study (2015-2017).

PARTICIPANTS

77 967 employees in the Finnish public sector, with a mean age of 51.9 (SD 13.1) years and 82% women.

OUTCOME MEASURES

Item response theory estimates: difficulty and discrimination parameters of the JSS and differences in these parameters between men and women.

RESULTS

The mean JSS total score was 6.4 (4.8) points. For all four items of the JSS, the difficulty parameter demonstrated a slight shift towards underestimation of the severity of sleep difficulties. The discrimination ability of all four items was moderate to high. For the JSS composite score, overall discrimination ability was moderate (0.98, 95% CI 0.97 to 0.99). Mild uniform DIF (p<0.001) was seen: two items showed better discrimination ability among men and two others among women.

CONCLUSIONS

The JSS showed overall good psychometric properties among this healthy population of employees in the Finnish public sector. The JSS was able to discriminate people with different severities of sleep disturbances. However, when using the JSS, the respondents might slightly underestimate the severity of these disturbances. While the JSS may produce slightly different results when answered by men and women, these sex-related differences are probably negligible when applied to clinical situations.

Multicultural Considerations for the Psychometrics of the Brief Pornography Screen

Problematic pornography use (PPU) is a burgeoning area of clinical interest. The Brief Pornography Screen (BPS) is a new PPU measure. The BPS has not been psychometrically studied within specific race/cultural groups. We sought to broaden the PPU literature by examining the confirmatory factor analysis (CFA) fit, measurement invariance, and structural invariance of the BPS across eight identity groups. Participants came from a survey administered at three U.S. universities. In total, n = 2,475 participants were analyzed, with the following identity group breakdowns: Asian American/Pacific Islander (AAPI) male = 268, AAPI female = 303, Black male = 101, Black female = 189, Latin male = 208, Latin female = 372, White male = 432, and White female = 602. BPS CFA fit was good across all groups. Measurement invariance analyses suggested metric, but not scalar invariance across all groups. We then split participants by sex assignment, full residual invariance was evident across groups for male participants and partial residual invariance was evident for female participants. Structural invariance analyses indicated anxiety as a weak positive BPS correlate in AAPI, Latin, and White male participants (β's = 0.25-0.27), but not meaningfully related in the other groups. Pornography viewing frequency was positively correlated with BPS scores across most groups with a wide range (β's = 0.29-0.52), except for Black male participants (β = 0.15). Our results suggest that the BPS is an appropriate PPU measure across the tested identity groups. While between-group measurement is relatively accurate within sex assignment groups, correlates differed in strength, meaning different variables likely predict PPU for different groups of people.

The stigma towards mental illness: Portuguese validation of the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC)

Background

Stigma toward mental illness significantly contributes to a lower quality of healthcare that can be provided. There are few studies on this topic in Portugal, so validating a scale that can evaluate and study the stigma is paramount. The aim of this study was to validate the Opening Minds Stigma Scale for Portuguese healthcare professionals.

Methods

A total of 503 participants were included in this study, and the majority was female (81.1%). The sample consisted mainly of psychologists (39.4%) and physicians (30.8%). Reliability and validity analyses were conducted and included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Results

Our results suggest that a 12-item model was the most appropriate (RMSEA = 0.026, SRMR = 0.057, CFI = 0.979, TLI = 0.973, GFI = 0.955) compared to our 15-item model and the original model. Items 8, 9 and 10 were removed. The 12-item scale's internal consistency was adequate (α = 0.71; ω = 0.72).

Conclusion

The 12-item model of the scale showed good reliability and validity and is appropriate for use with Portuguese healthcare professionals.

A comparison of the original major depression inventory with a modified version: A Danish validation study

BACKGROUND

The Major Depression Inventory (MDI) is a patient-reported outcome measure used by general practitioners to assist with diagnosing and evaluation of the severity of a patient's depression. However, recent studies have questioned the structural validity of the MDI.

OBJECTIVES

We proposed a modified version (mMDI) of the MDI with fewer response categories and four rephrased items and aimed to compare the psychometric properties of the changes in a joint cohort of patients from general practice and mental health associations.

METHODS

We used Rasch analysis, confirmatory factor analysis, and the area under the receiver operating curve (AUROC) to assess the validity and reliability of the two versions. Equipercentile linking was used to compute cut-off points for the mMDI.

RESULTS

For both versions, local dependence was found between the three item pairs (loss of interest, lack of energy), (lack of self-confidence, feelings of guilt), and (concentration problems, feeling restless/slowed down). The mMDI displayed lower measurement error in the upper end of the scale and better item level fit for three of the four reformulated items compared to the MDI. For the MDI, 5.3% of the respondents gave improbable responses; the corresponding number was 3.4% for the mMDI. The mMDI displayed better fit to a one-factor model compared to the MDI. When comparing the correlation of the scales with the WHO-5 instrument, the corresponding AUROC estimates for the mMDI and MDI were found to be 0.93 (0.92; 0.96) and 0.91 (0.87; 0.94), respectively. The cut-off points for mild, moderate, and severe depression in the mMDI were found to be 17, 20, and 23, respectively.

CONCLUSION

The proposed changes of the MDI are psychometrically sound upgrades of the original.

Benefits of the Curious Behavior of Bayesian Hierarchical Item Response Theory Models-An in-Depth Investigation and Bias Correction

When using Bayesian hierarchical modeling, a popular approach for Item Response Theory (IRT) models, researchers typically face a tradeoff between the precision and accuracy of the item parameter estimates. Given the pooling principle and variance-dependent shrinkage, the expected behavior of Bayesian hierarchical IRT models is to deliver more precise but biased item parameter estimates, compared to those obtained in nonhierarchical models. Previous research, however, points out the possibility that, in the context of the two-parameter logistic IRT model, the aforementioned tradeoff has not to be made. With a comprehensive simulation study, we provide an in-depth investigation into this possibility. The results show a superior performance, in terms of bias, RMSE and precision, of the hierarchical specifications compared to the nonhierarchical counterpart. Under certain conditions, the bias in the item parameter estimates is independent of the bias in the variance components. Moreover, we provide a bias correction procedure for item discrimination parameter estimates. In sum, we show that IRT models create a unique situation where the Bayesian hierarchical approach indeed yields parameter estimates that are not only more precise, but also more accurate, compared to nonhierarchical approaches. We discuss this beneficial behavior from both theoretical and applied point of views.

Outcome metrics utilized in evaluations of programs and interventions for combat and operational stress: A review of psychometric properties

The Department of Defense has mandated combat and operational stress control (COSC) efforts for the Services since 1999. Although several COSC-related programs have been implemented, few have undergone evaluation, and no standardized metrics have been established to assess their effectiveness and utility. The purpose of this review was to characterize the content and psychometrics of measures that have been utilized as outcome metrics in evaluations of COSC-related programs and interventions. Systematic literature searches were conducted for publications that: a) evaluated at least one measure from U.S. service members who participated in a program or intervention to prevent or reduce the adverse effects of combat and operational stress; and b) reported U.S. data on the internal consistency, test-retest reliability, convergent validity, and sensitivity/specificity of the identified measures. This process identified 15 measures for which psychometric properties were reviewed for acceptability based on recommended criteria. Identified measures varied from well-validated measures to newer instruments for which more data is needed on one or more of the target psychometric properties. Aside from internal consistency, psychometric data from U.S. military samples were sparse. Results further suggested that some measures might have reduced sensitivity in service members under certain conditions, such as large-scale screening. Additional studies are needed to validate COSC-relevant measures in service members. Future evaluations of programs and interventions for combat and operational stress should select measures that will increase the consistency of the literature, allow comparisons across studies, and ensure alignment with the objectives of identified programs.

Psychometric properties of the Buss-Perry Aggression Questionnaire-short form among law enforcement officers

Repeatedly capturing national headlines, excessive law enforcement officer (LEO) use of force in critical incident encounters is one of the most divisive human rights issues in the United States. Valid and reliable measures of potential precursors to LEO excessive use of force, such as aggression, are needed. The Buss-Perry Aggression Questionnaire-short form (BPAQ-SF) is a validated measure of aggression across various populations; however, evaluation of this easily administered measure in high-stress, frontline populations such as LEOs is limited. The primary goal of this study was to evaluate the validity, reliability, and sensitivity to change the BPAQ-SF in a sample of LEOs. A confirmatory factor analysis suggested that the hierarchical solution provides a mixed fit to the data: SBχ²(25.84)  = 62.50, p = .0001; comparative fit index = .94, non-normed fit index = .92, root mean square error of approximation = .19 (90% confidence interval = .17-.21), standardized root mean squared residual = .08. The BPAQ-SF demonstrated good internal consistency (α = .84) and test-retest reliability (r = .86), correlations in the expected direction with predictors of and buffers against aggression, and sensitivity to change among LEOs who participated in an intervention targeting aggression. Results support and extend previous findings suggesting that the BPAQ-SF is a valid and reliable measure of aggression among LEOs.

Child and adolescent participation measurement tools and their translations: A systematic review

BACKGROUND

Numerous participation measurement tools targeting children and youth have been developed. Despite the translation of these tools into specific languages and cultures, the reliability and validity of the translated versions remain uncertain. To address this gap in knowledge, this study aims to identify tools for assessing the participation of children aged 5-18 years and to appraise the psychometric properties of their translated versions.

METHODS

Four electronic databases were searched for peer-reviewed studies published in English. Preferred Reporting Items for Systematic Reviews guidelines was followed. Study titles and abstracts were screened by four independent reviewers. Data were extracted for both original and translated versions of eligible tools. Instrument quality assessments were performed using the Outcome Measures Rating Form Guidelines. Any discrepancies were resolved by consensus.

RESULTS

Out of the 31 measurement tools examined, 18 tools had at least one translated version available, and among those original measurement tools, a total of 58 translated versions were identified. The most widely translated tool was the Physical Activity Questionnaire for Children (12 languages), and the most frequently translated language was Chinese (7 tools). Most translated versions verified internal consistency and content validity. Only three translated versions were verified inter-rater reliability, and seven translated versions were tested criterion validity with the gold standard tools assessing participation of children (e.g., accelerometer, Pediatric Evaluation of Disability Inventory and four 24-h recalls). None of the translated versions were tested for intra-rater reliability and responsiveness.

CONCLUSIONS

These findings can support the selection of psychometrically sound tools for children with disabilities, given their culture and language, and tool quality.

Investigating the psychometric properties of PaRCADS-Parenting to Reduce Child Anxiety and Depression Scale in a Norwegian sample

OBJECTIVES

Parents play a pivotal role in child development and several parental factors have been identified as risk or protective factors for childhood anxiety and depression. To assess and target these parental factors in interventions, there is a need for a comprehensive, easy-to-use instrument.

METHOD

This study aimed to investigate the psychometric properties of an adapted version of the Parenting to Reduce Child Anxiety and Depression Scale, PaRCADS(N) in a Norwegian community sample (N = 163) of parents of children aged 8-12 years.

RESULTS

Our findings indicate that PaRCADS(N) has acceptable psychometric properties. These results are comparable to those of the original study of the PaRCADS in Australia.

CONCLUSION

Based on these results, we recommend that PaRCADS(N) can be utilized by health care workers as a tool for assessment and identification of parental practices related to child anxiety and/or depression to target relevant risk and protective factors in treatment and prevention.