Cross-cultural adaptation and validation of the Willingness to Care Scale for elder care in Chinese adults.

This study aimed to translate the English version of the Charité Alarm Fatigue Questionnaire (not the original German version) into Chinese and evaluate its psychometric properties among ICU healthcare professionals in China. The Charité Alarm Fatigue Questionnaire was translated into Chinese following Brislin's translation model and finalized after a pre-survey. A total of 674 questionnaires were distributed. The 634 valid responses were randomly split into two subsamples for exploratory factor analysis (n = 317) and confirmatory factor analysis (n = 317). Item analysis was performed using the critical ratio method, correlation coefficient method, and homogeneity test. Validity was assessed through content validity, construct validity, convergent validity, discriminant validity, and criterion-related validity. Reliability was evaluated using Cronbach's α coefficient, McDonald's ω coefficient, split-half reliability, and test-retest reliability. The Chinese version consisted of 9 items and 2 dimensions, with a cumulative variance contribution rate of 68.346%. The item-level content validity index ranged from 0.80 to 1.00, and the scale-level content validity index/average was 0.954. The average variance extracted and composite reliability values for each dimension met the criteria, demonstrating good convergent and discriminant validity. The criterion-related validity was 0.567. Cronbach's α coefficient was 0.855, McDonald's ω coefficient was 0.842, split-half reliability was 0.871, and the test-retest reliability was 0.719. No significant floor or ceiling effects were observed. The Chinese version demonstrates good psychometric properties and can be considered a valid tool for assessing alarm fatigue levels in China.

Objective: To translate the food allergy quality of life-parental burden (FAQL-PB) scale into Chinese and test its reliability and validity among the caregivers of children with food allergy. Methods: The caregivers of 222 children with food allergy were enrolled by convenient sampling from October 2020 to October 2021 in the Children's Hospital Affiliated to Chongqing Medical University. The forward-backward translation and cultural adaptation of the original FAQL-PB scale was performed in accordance with Brislin's model. Item analysis was used to select items. The validity of the questionnaire was analyzed with the item-level content validity and the exploratory factors analysis. And the internal consistency coefficient, split-half reliability and test-retest reliability were used to evaluate the reliability of the questionnaire. Results: The Pearson correlation coefficients of the scores between each item and total scale ranged from 0.72 to 0.88 (P<0.01). The item-level content validity index (I-CVI) ranged from 0.83 to 1.00, scale-level content validity index/universal agreement (S-CVI/UA) was 0.94, and scale-level content validity index/average (S-CVI/Ave) was 0.99. Exploratory factor analysis revealed that Chinese version of FAQL-PB scale could be classified into two dimensions: emotional distress and limitations on life, with the accumulative variance contribution rate of 74.08%. The Cronbach's α coefficient, split-half reliability coefficient and test-retest reliability of the Chinese version of FAQL-PB scale were 0.97, 0.98 and 0.71, respectively. Conclusion: The Chinese version of FAQL-PB scale is proved to be reliable and eligible, and can be used as a specific tool to investigate the quality of life in family of children with food hypersensitivity.

BackgroundA prevalent challenge in neuropsychological assessment, particularly when utilizing instruments designed for controlled laboratory environments, is that the outcomes may not correspond to an individual’s real-life status. Accordingly, assessments of visuospatial working memory (VSWM) conducted in such settings might fail to capture certain facets of this function, as it operates in real life. On the other hand, entirely ecological assessments may risk compromising internal validity. This study aimed to develop an intermediate mode of assessment that measures VSWM in older adults by employing a setting, a task, and a response format that aligns closely with both laboratory and ecological assessments. Furthermore, a preliminary investigation was carried out to study the variations in spatial cognition among different demographic groups.MethodsIn a two-session study, 77 healthy older adults, eight patients with mild cognitive impairment (MCI), and seven patients with Alzheimer’s disease (AD) were recruited to complete the wayfinding questionnaire (WQ), the Corsi block-tapping task (CBTT), and the Spatial Memory Table (SMT). The SMT is a novel instrument developed specifically for this study, aiming to provide a more accurate measure of VSWM performance in older adults’ everyday life. Test-retest and split-half reliabilities, as well as the face, content, concurrent, convergent, and known-groups validities, were analyzed to investigate the psychometric properties of the SMT.ResultsThe analyses were mainly centered on studying the psychometric properties of the SMT. Test-retest reliability (r = .753, p < .001) and split-half reliability (ρSC = 0.747) were found to be acceptable. Concurrent validity using CBTT (r = .264, p = .021), convergent validity using WQ subscales (navigation and orientation: r = .282, p = .014; distance estimation: r = .261, p = .024), and known-groups validity using the SMT scores among people with MCI and AD (χ2 = 35.194, df = 2, p < .001) were also indicative of the instrument’s good validity. Data analysis also revealed acceptable levels of face validity (U = 4.50; p = .095) and content validity (CVR ≥ 0.60). As a result of comparing VSWM and wayfinding variables across genders and education levels, a significant difference was observed for navigation and orientation and spatial anxiety between women and men (p < .05). None of the variables were different among education levels.ConclusionThe SMT was found to be a reliable and valid tool for measuring VSWM performance in older adults. Given these findings, the SMT can be regarded as a measure that sufficiently approximates both laboratory and real-life demands for VSWM. Additionally, the instrument demonstrated a preliminary acceptable capacity to differentiate between healthy individuals and those with MCI and AD.

Psychometric validation of the Chinese version of the Edmonton-33 scale inpatients with head and neck cancer.

Patients from different social environments and cultural backgrounds have different nursing needs. If nurses ignore the cultural differences of patients, it is easy to lead to the strained nurse-patient relationship, affect the nursing effect and cause harm to patients. Critical cultural competence (CCC) can help nurses to meet the nursing needs of patients from different cultural backgrounds, which is beneficial to building a harmonious nurse-patient relationship and improving the quality of nursing. Almutairi, et al designed the Critical Cultural Competence Scale (CCCS) which can be used to evaluate accurately nurses' CCC. No studies have reported the development of a critical cultural competence measurement tool for nurses or the introduction of foreign scales in China. This study aims to conduct Chinese and cross-cultural debugging and test the reliability of the English version of the CCCS in order to form CCCS suitable for Chinese cultural background and provide an effective evaluation tool for investigating the current situation of clinical nurses' CCC. This study used Brislin's back-translation model to translate and back-translation the English version of CCCS. The Chinese version of CCCS was then created through cross-cultural debugging by expert consultation and a pre-survey with a sample size of 30 clinical nurses. From August to October 2019, 580 clinical nurses were surveyed using a whole group sampling method. The participants were randomly divided into 2 groups with a 7꞉3 ratio. One group (n=406) was used for exploratory factor analysis and reliability analysis, while the other group (n=174) was used for confirmatory factor analysis. Six experts used the scale-level content validity index (S-CVI) and the item-level content validity index (I-CVI) to assess content validity. In the exploratory factor analysis, items were screened using the critical ratio method, and were tested using the KMO (Kalser-Meyer-Olkin) index, Bartlett's sphericity test, and principal component analysis. In the confirmatory factor analysis, average variance extracted (AVE), goodness of fit index (GFI), adjusted goodness of fit index (AGFI), and root mean square error of approximation (RMSEA) were used to assess the degree of fit of the constructed model. For the total scale and the 4 subscales, the Cronbach's α coefficient, split-half reliability, and retest reliability were used to assess the scale's reliability. The S-CVI was 0.930, while the I-CVI ranged from 0.833 to 0.944. For all items, the critical ratio exceeded 3, and the difference between the high and low subgroups was statistically significant (P<0.05). Exploratory factor analysis revealed critical knowledge subscale had a KMO value of 0.676, with the total scale and other 3 subscales all having a KMO value >0.8 and a chi-square value of 814.32 to 12 442.45 for the Bartlett's spherical test, with degree of freedom ranging from 21 to 136 (P<0.001), indicating that all items were suitable for factor analysis. The principal component analysis showed that 17, 12, 7, and 7 items were extracted from the 4 subscales, with 4, 3, 2, and 2 components whose eigenvalues were more than 1, and the cumulative variance contribution was 66.0%, 54.3%, 56.6%, and 70.2%, respectively. The confirmatory factor analysis showed that the AVE of the 4 subscales were 0.637, 0.499, 0.560, and 0.565, GFI was 0.904, AGFI was 0.863, and RMSEA was 0.076. The Cronbach's α coefficient for the total scale and subscales ranged from 0.811 to 0.878, the split-half reliability ranged from 0.707 to 0.842, and the retest reliability was 0.827. The Chinese version of the CCCS has good reliability and validity, and it can be used as a valid assessment tool for clinical nurses' critical cultural competence in China.

This study aimed to translate and validate The Resilience Scale for Kidney Transplantation (RS-KTPL) into Chinese and assess its reliability and validity among kidney transplant patients in China. With authorization from the original authors, the RS-KTPL was translated following Brislin's translation model, including forward translation, back translation, author review, cross-cultural adaptation, and a pilot study, resulting in a Chinese version of the RS-KTPL. A total of 358 kidney transplant recipients were recruited through convenience sampling and completed the questionnaire. Statistical analyses included item analysis, content validity, structural validity, convergent validity, discriminant validity, and reliability. Item analysis led to the removal of certain items that did not meet the criteria, resulting in a final version of the scale with 22 items across four dimensions. For content validity, the item-level content validity index (I-CVI) ranged from 0.83 to 1.000, and the scale-level content validity index (S-CVI/Ave) was 0.91, indicating good content fit. Structural validity was confirmed through exploratory and confirmatory factor analyses, supporting a four-factor structure with a cumulative variance contribution rate of 64.913% and all factor loadings exceeding 0.5. Convergent and discriminant validity analyses showed that the composite reliability (CR) values ranged from 0.741 to 0.938, and the average variance extracted (AVE) values ranged from 0.5 to 0.704, with the square root of AVE being higher than the inter-factor correlation coefficients, indicating good internal consistency and discriminating ability. Reliability testing showed a Cronbach's α coefficient of 0.944 for the overall scale, with subscale Cronbach's α coefficients all above 0.696, and a split-half reliability of 0.891, demonstrating high internal consistency and stability of the scale. The Chinese version of the RS-KTPL exhibits good reliability and validity among kidney transplant patients in China and can be effectively used to assess psychological resilience in this population.

ObjectiveThis study aimed to translate and validate The Resilience Scale for Kidney Transplantation (RS-KTPL) into Chinese and assess its reliability and validity among kidney transplant patients in China.MethodsWith authorization from the original authors, the RS-KTPL was translated following Brislin’s translation model, including forward translation, back translation, author review, cross-cultural adaptation, and a pilot study, resulting in a Chinese version of the RS-KTPL. A total of 358 kidney transplant recipients were recruited through convenience sampling and completed the questionnaire. Statistical analyses included item analysis, content validity, structural validity, convergent validity, discriminant validity, and reliability.ResultsItem analysis led to the removal of certain items that did not meet the criteria, resulting in a final version of the scale with 22 items across four dimensions. For content validity, the item-level content validity index (I-CVI) ranged from 0.83 to 1.000, and the scale-level content validity index (S-CVI/Ave) was 0.91, indicating good content fit. Structural validity was confirmed through exploratory and confirmatory factor analyses, supporting a four-factor structure with a cumulative variance contribution rate of 64.913% and all factor loadings exceeding 0.5. Convergent and discriminant validity analyses showed that the composite reliability (CR) values ranged from 0.741 to 0.938, and the average variance extracted (AVE) values ranged from 0.5 to 0.704, with the square root of AVE being higher than the inter-factor correlation coefficients, indicating good internal consistency and discriminating ability. Reliability testing showed a Cronbach’s α coefficient of 0.944 for the overall scale, with subscale Cronbach’s α coefficients all above 0.696, and a split-half reliability of 0.891, demonstrating high internal consistency and stability of the scale.ConclusionThe Chinese version of the RS-KTPL exhibits good reliability and validity among kidney transplant patients in China and can be effectively used to assess psychological resilience in this population.

Chronic pancreatitis (CP) is a chronic fibroinflammatory pancreatic disease that severely impacts patients' quality of life (QoL). The Pancreatitis Quality of Life Instrument (PANQOLI) is an 18-item measure specifically designed to assess QoL amongst patients with CP. This study aimed to develop a Chinese version of PANQOLI and assess its reliability and validity in the Chinese CP cohort. Translation was performed according to forward-backwards translation steps and transcultural adaptation. Five hundred Mandarin Chinese-speaking patients with CP were enrolled, 250 for the exploratory factor analysis (EFA) and 250 for the confirmatory factor analysis (CFA). Item analysis, reliability analysis (internal consistency, split-half reliability, test-retest reliability), and validity analysis (content validity, construct validity, and convergent validity) were performed. Item analysis of the Chinese version of PANQOLI revealed that the absolute t values of all items were > 3. Reliability analysis showed that Cronbach's α coefficient was 0.868, split-half coefficient was 0.934, and intraclass correlation coefficient was 0.859, demonstrating excellent reliability. For content validity, item level content validity index (I-CVI) ranged from 0.8 to 1.0, and average of I-CVI scores across all items (S-CVI/Ave) was 0.91. In construct validity analysis, EFA produced four dimensions after rotation, and results of CFA showed χ2/df = 2.346, comparative fit index (CFI) = 0.929, Tucker-Lewis index (TLI) = 0.915, and root-mean-square error of approximation (RMSEA) = 0.074. The analysis of convergent validity indicated that the Chinese version of PANQOLI was moderately correlated with the physical (r = 0.436, P < 0.001) and mental component summary (r = 0.518, P < 0.001) of the 36-Item Short Form Health Survey. The Chinese version of PANQOLI appears to be culturally appropriate, reliable, and valid for assessing the QoL amongst Chinese patients with CP.

Fostering a strong professional identity (PI) enhances career fulfillment. In China, therapy education is undergoing development, integrating both Western and traditional health concepts, causing inconsistent PI among therapy students. To date, no validated tools exist to measure and monitor PI of Chinese therapy students. This study aimed to translate and validate the 9-item MacLeod Clark Professional Identity Scale (MCPIS-9) for this purpose. This study involved translation and cultural adaptation of the MCPIS-9, followed by a rigorous assessment of its model fit and psychometric properties using data collected via an online questionnaire. A forward- and backward- translation process was conducted. Content validity was evaluated using item-level content validity index (I-CVI) and scale level content validity index average method (S-CVI/Ave). Therapy students across all grades at undergraduate and postgraduate levels in China were eligible. Exploratory factor analysis (EFA) examined the underlying factor structure. Model fit was evaluated through confirmatory factor analysis (CFA) using the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR) and Root Mean Square of Error of Approximation (RMSEA). Convergent validity was assessed through Pearson's correlations coefficient (r) with the Professional Identity Scale for Health Students and Professionals (PISHSP). Internal consistency was examined using Cronbach's Alpha (Cα) and McDonald's Omega (ω). A total of 1054 students participated. Content validity was excellent (I-CVI = 0.86-1.0, S-CVI/Ave = 0.98). EFA indicated a two-factor structure with acceptable model fit (CFI = 0.978; TLI = 0.968; SRMR = 0.033; RMSEA = 0.063). Reliability was strong (Cα = 0.835; ω = 0.817). Convergent validity demonstrated a strong correlation (r = 0.75) with the PISHSP. The Chinese MCPIS-9 is a reliable and valid tool for assessing PI among therapy students. Future research could focus on refining item 4 of this tool, potentially through further exploration of therapy students' perceptions of PI within the unique context of the Chinese healthcare system.

In the postpandemic context, the surge of digital health information has intensified public demand for clear and practical communication, particularly in China, where health literacy disparities persist. The Clear Communication Index, developed by the US Centers for Disease Control and Prevention (CDC), is a standardized tool for assessing the clarity and actionability of health materials, but no version adapted to the simplified Chinese context has been established. This study aims to translate and culturally adapt the Clear Communication Index into simplified Chinese, and subsequently validate its psychometric properties using diabetes health communication materials from provincial CDCs across Mainland China, a disease area with a substantial public health burden and strong reliance on health education. Following a standardized cross-cultural process (forward-back translation and expert review), we developed the simplified Chinese version of the Clear Communication Index (C-CCI) and finalized a 12-item scale across 4 dimensions (Main Message and Call to Action, Behavioral Recommendations, Numbers, Risk) with yes or no scoring (0-100). One top-ranked diabetes health education material was sampled from each provincial CDC website in Mainland China (30/31 included; 96.8%) on May 18, 2025. Twelve raters with multidisciplinary backgrounds completed a 3-week standardized training program and independently evaluated each article (360 ratings). Structural validity was examined using exploratory factor analysis and confirmatory factor analysis. Content validity was assessed by the item-level content validity index and the scale-level content validity index/average. Reliability was evaluated by internal consistency (Cronbach α) and inter-rater agreement (Fleiss kappa), while convergent/discriminant validity was assessed using composite reliability and average variance extracted (AVE). The 4-factor structure was supported. Content validity was high, with the scale-level content validity index/average values of 0.976 for clarity and 1 for relevance. Overall reliability was acceptable (Cronbach α=0.837), with particularly strong internal consistency in the Risk dimension (Cronbach α=0.910). Inter-rater agreement was substantial (κ=0.624). Convergent validity (composite reliability=0.897-0.914; AVE=0.645-0.831) and discriminant validity were satisfactory. Application to 30 provincial CDC websites yielded a mean C-CCI score of 53.84 (SD 29.74), well below the recommended threshold of 90. No significant regional differences were observed in total scores; however, Behavioral Recommendations scored slightly higher in western provinces than in eastern and central regions (η²=0.034), representing a small effect size with limited practical significance. The C-CCI demonstrated good validity, reliability, and feasibility for evaluating simplified Chinese health communication materials. These findings underscore the need to strengthen health communication practices in China and encourage provincial CDCs to align material development with national health literacy goals. Integrating the C-CCI into routine CDC review protocols could support evidence-based quality assurance and advance clearer, more actionable public health communication nationwide.

BackgroundThis study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument’s acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF).MethodsThe translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity.ResultsThe Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83–1.00, average CVI: 0.98), internal consistency (Cronbach’s alpha: 0.72–0.89; MacDonald’s omega: 0.82–0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79–0.95). Confirmatory factor analysis confirmed the instrument’s two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value < 0.001; root mean square error of approximation [RMSEA]: 0.051; comparative fix index [CFI]: 0.945, Tucker-Lewis index [TLI]: 0.937; standardised root mean-squared error [SRMR]: 0.058). The Malay-AQoL-6D’s concurrent validity was evident through its good agreement with EQ-5D-5L. Multiple hypothesis tests further affirmed its construct and known-group validity. The Malay-AQoL-6D’s psychometric properties remained consistent across different missing data techniques.ConclusionThe findings suggest that Malay-AQoL-6D could be a culturally acceptable, reliable, and valid HRQoL measure for quantifying HRQoL among the local HF population. Future studies are necessary to further validate the instrument against other measures and confirm the instrument’s test-retest reliability and responsiveness, which are possible with the availability of the Malay-AQoL-6D.

Cross-cultural adaptation and validation of the Chinese version of the Malnutrition Awareness Scale among community-dwelling older adults.

Persistent somatic symptoms (PSS) refer to a group of clinical syndromes characterized by recurrent or persistent bodily discomfort lasting ≥ 3 months, such as chronic fatigue, refractory dizziness, and persistent pain. Patients with PSS often face stigma due to the absence of a clear organic etiology, which can exacerbate psychological distress, reduce treatment adherence, and hinder timely medical help-seeking. Healthcare professionals’ biased perceptions or othering toward PSS may further impede accurate diagnosis and optimal care. To date, no standardized tool is available in China to measure stigma among healthcare professionals toward PSS. This study aimed to translate the Persistent Somatic Symptom Stigma Scale for Healthcare Professionals (PSSS-HCP) into Chinese (PSSS-HCP-C), conduct cross-cultural adaptation, and examine its reliability and validity in a sample of Chinese healthcare professionals. Following Brislin’s translation model, the original PSSS-HCP was forward-translated, synthesized, back-translated, reviewed by an expert committee, and pretested for cultural adaptation. A convenience sample of 282 healthcare professionals was recruited from March to April 2025 for psychometric testing, with 30 participants completing the retest after two weeks. Content validity was assessed by the content validity index. Construct validity was examined using exploratory factor analysis. Reliability was evaluated by Cronbach’s α, split-half reliability, and test-retest reliability. The Chinese version of the PSSS-HCP comprised 13 items across three dimensions: othering, uneasiness in interaction, and non-disclosure. The item-level content validity index (CVI) ranged from 0.80 to 1.00, with a scale-level CVI of 0.946. Exploratory factor analysis (EFA) extracted three common factors, explaining 66.692% of the total variance, with factor loadings between 0.743 and 0.885. The overall Cronbach’s α was 0.867, with subscale α coefficients ranging from 0.817 to 0.872. The split-half reliability was 0.798, and the test-retest reliability was 0.897. The Chinese version of the PSSS-HCP demonstrated satisfactory reliability and validity and can be used to assess healthcare professionals’ stigma toward patients with PSS in China. This tool provides a robust measurement basis for developing interventions to reduce stigma, enhance clinical attitudes, and inform policy-making in PSS management. not applicable.

Background The aim was to develop a diagnostic questionnaire for damp phlegm pattern and blood stasis pattern in coronary heart disease patients (CHD-DPBSPQ). Methods The standard procedures of questionnaire development were carried out to develop and assess CHD-DPBSPQ. The patients were assessed using the CHD-DPBSPQ, CHD-DPPQ, and CHD-BSPQ. Four methods were used to select the items on the CHD-DPBSPQ in a pilot study based on data from a Guizhou tertiary grade A hospital. Cronbach's alpha and the split-half reliability, test-retest reliability, content validity, criterion validity, construct validity, and convergent validity were determined in a validation study using a nationwide sample. Results After item selection, the CHD-DPBSPQ contained 15 items in two domains: the phlegm domain (9 items) and the blood stasis domain (6 items). For the CHD-DPBSPQ, the alpha coefficient was 0.88, the split-half coefficient was 0.90, and the intraclass correlation coefficient was 0.83. The range of the item-level content validity index (I-CVI) was 0.71 to 1.0 and that of the scale-level content validity index/average (Scale-CVI/Ave) was 0.97. The domain scores on the CHD-DPBSPQ were in close relation to the scores on a questionnaire for damp phlegm pattern in coronary heart disease patients (CHD-DPPQ) and a questionnaire for blood stasis pattern in coronary heart disease patient (CHD-BSPQ) (P < 0.01). The root mean square error of approximation (RMSEA) was equal to 0.05 (90% CI: 0.044, 0.059). Convergent validity was demonstrated with a moderate correlation. Conclusion The CHD-DPBSPQ is a reliable and valid instrument.

Compression therapy with the use of graduated compression stockings (GCSs) is a common treatment strategy for chronic venous disease (CVD). However, there is no uniform and objective standard to assess adherence to the use of GCSs. The aim of this study is to develop and validate a GCS Compliance Scale (GCSAS) to fill gaps in internationally recognized comprehensive scales and provide a useful tool for future research. The items included in the GCSAS were based on a review of the literature and open-ended interviews with experts, who screened the initial items using an item-level content validity index. Then, pilot tests were conducted three times with 50 participants. After exclusion of redundant and cross-loading items by exploratory factor analysis, 290 subjects were recruited to evaluate the reliability and validity of the proposed GCSAS. Analyses included internal consistency, test-retest reliability, split-half reliability, construct validity, criterion validity, convergent validity, and discriminant validity. The final GCSAS consisted of 17 items and 5 dimensions. The results of the exploratory factor analysis indicated that the variances of each factor explained were 22.03%, 14.85%, 14.74%, 14.16%, and 13.35%, and all 5 factors explained 79.13% of the variance among the 17 items. The factor loadings of all items were >0.7. Confirmatory factor analysis indicated that the indices were adequate. A significant positive correlation was found between the GCSAS and the Venous Insufficiency Epidemiological and Economic Study - Quality of Life questionnaire scores (r = 0.76, p < 0.001). The Cronbach's alpha coefficient was 0.90, test-retest reliability was 0.81, and split-half reliability was 0.92. The GCSAS showed good validity and reliability to assess compliance with the use of GCSs among patients with CVD.