Development and psychometric validation of the Japanese version of the pediatric eating assessment tool (PediEAT-J)

In this updated Self-Care of Coronary Heart Disease Inventory (SC-CHDI) v3.0, items were added to better reflect the theory of self-care of chronic illness and revised based on recent research. The expanded SC-CHDI now reflects the theoretical concepts of self-care maintenance, monitoring, and management. The aim of this study was to evaluate the psychometric properties of the SC-CHDI v3.0. In a sample of adults with coronary heart disease, we tested the SC-CHDI v3.0 validity with confirmatory factor analysis. Reliability was calculated using Cronbach α, factor score determinacy coefficient, and global reliability index for multidimensional scales, with values > 0.70 considered adequate. The sample (n = 205) was predominantly male (79%) with a mean age of 65.3 ± 11.1 years. The self-care maintenance scale encompassed 2 distinct behaviors, namely, "illness related behaviors" and "health promoting behaviors," which reflect consulting and autonomous dimensions, respectively. The goodness-of-fit indices were adequate: χ2(25, N = 205) =31.86, P = .16, comparative fit index = 0.97, Tucker-Lewis Index = 0.95, root mean square error of approximation = 0.04 (90% confidence interval, 0.00-0.07), P = .705, and standardized root mean square residual = 0.045. Analysis of the new self-care monitoring scale yielded a single factor; goodness-of-fit indices were excellent: χ2(12, N = 205) =11.56, P = .48, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation < 0.001 (90% confidence interval, 0.000-0.07), P = .86, and standardized root mean square residual = 0.02. The self-care management scale had 2 dimensions of autonomous and consulting behavior with strong goodness-of-fit indices: χ2(7, N = 205) =6.57, P = .47, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation ≤ 0.001 (90% confidence interval, 0.00-0.08), P = .76, and standardized root mean square residual = 0.02. Reliability estimates were ≥0.80 for all scales. Our testing suggests that the SC-CHDI v3.0 is a sound measure of the essential elements of self-care for adults with coronary heart disease.

Outcome evaluations using patient-reported outcome measures (PROMs) are becoming increasingly important in healthcare, including long-term care and disability support. The Adult Social Care Outcomes Toolkit (ASCOT) is a self-reported measure that assesses social care-related quality of life (SCRQoL), which can be affected by long-term care services. This study examined the validity and reliability of the Japanese ASCOT four-level Self-Completion Tool (SCT4) for people with mental illnesses who used community services. We conducted a cross-sectional survey of persons with mental illnesses who used community services in 22 facilities across Japan. Confirmatory factor analysis (CFA) was performed to confirm the factor structure. Spearman’s rank correlation coefficients were calculated to assess the convergent validity of health-related quality of life (HRQoL), personal agency, well-being, depressive symptoms, functional assessment, and objective quality of life (QoL). Cronbach’s alpha and intra-class correlation coefficients (ICC) were computed to assess internal consistency and test-retest reliability, respectively. In total, 397 service users agreed to participate, and 64 completed the Japanese ASCOT SCT4 twice to assess test-retest reliability. The model fit indices indicated chi-squared statistic /degrees of freedom (CMIN/df) = 1.069 (p = 0.375), root mean square error of approximation (RMSEA) = 0.013, standardized root mean square residual (SRMR) = 0.026, comparative fit index (CFI) = 0.998, and Tucker-Lewis index (TLI) = 0.997. The Japanese ASCOT SCT4 demonstrated significant correlations with HRQoL (ρ = 0.619, p < 0.001), personal agency (ρ = 0.502, p < 0.001), well-being (ρ = 0.657, p < 0.001), depressive symptoms (ρ = -0.657, p < 0.001), and functional assessment (self-reported version: ρ = -0.616, p < 0.001; observer-reported version: ρ = -0.242, p < 0.001), and objective QoL (ρ = 0.240, p < 0.001). Cronbach’s alpha and ICC were 0.76 and 0.71, respectively. The Japanese ASCOT SCT4 can be potentially useful as a PROM to easily assess the SCRQoL of individuals with mental illness who use community services. Future studies should use additional validity tests with more diverse samples.

BackgroundFrozen Shoulder (FS) is a painful condition characterized by severe pain and progressive restriction of shoulder movement, leading to functional impairment and reduced quality of life. While different Patient Reported Outcome Measurements (PROMs) tools exist for assessing shoulder diseases, few specific PROMs are validated for FS patients.PurposeThis study aims to assess the psychometric properties of the Disability of Arm, Shoulder, and Hand (DASH) questionnaire in FS patients.MethodsOne hundred and twenty-four subjects (mean ± SD age = 55.4 ± 7.9 years; 55.6% female) diagnosed with FS were included and completed the DASH questionnaire, the Numerical Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), and the Short-Form Health Survey 36 (SF-36). Floor or ceiling effects were investigated. Structural validity was analysed through a unidimensional Confirmatory Factor Analysis (CFA), internal consistency through Cronbach’s alpha, test-retest reliability through the Intraclass Correlation coefficient (ICC), measurement error through the Standard Error of Measurement (SEM), and the Minimum Detectable Change (MDC), and construct validity through the hypothesis testing with the correlation with the other outcome measures used.ResultsNo floor or ceiling effects were observed. CFA confirmed a one-factor structure after addressing local item dependency (Root Mean Square Error of Approximation = 0.055; Standardized Root Mean Square Residual = 0.077; Comparative Fit Index = 0.970; Tucker-Lewis Index = 0.968). Cronbach’s alpha was high (= 0.951), and test-retest reliability was excellent (ICC = 0.999; 95% CI: 0.998-1.000). SEM was equal to 0.5 points, and MDC to 1.5 points. Construct validity was considered satisfactory as 80% of the a-priori hypotheses were met.ConclusionThe DASH questionnaire demonstrated good psychometric properties in FS patients, supporting its use as a valuable tool for assessing the impact of FS in clinical and research settings.

BackgroundStress resilience is a dynamic process shaped by the interaction between demands and adaptive resources. Existing measures assess stress and resilience as separate constructs, limiting their use in digital health and workplace interventions. An integrated measure capturing both domains is needed.ObjectiveWe developed and validated the WONE Index, a multidimensional stress resilience tool designed to measure both current stress load and adaptive resources among full-time working adults.MethodsWe developed the 32-item WONE Index through literature review, expert consultation, and iterative refinement to assess stress load and resilience resources across behavioral, cognitive, and social domains. Phase 1 (N=1005; United States– or United Kingdom–based full-time employees) evaluated the initial item pool using exploratory and confirmatory factor analyses to establish the preliminary factor structure and assess reliability and validity. Phase 2 (N=306; United States–based adults) expanded underperforming domains, refined items, and tested incremental validity, test-retest reliability, and measurement invariance. Data were collected online through CloudResearch (Connect) and Prolific (Prolific Academic Ltd) using secure survey platforms.ResultsPhase 1 supported a 2-domain structure: a Stress Load factor (Work Stress, Personal Stress, and Burnout) and a Resilience Resources factor (Emotion Regulation and Coping, Social Connectedness, and Sleep). Model fit indices were excellent (comparative fit index, CFI=0.95; Tucker-Lewis index, TLI=0.94; and root mean square error of approximation, RMSEA=0.05). Phase 2 replicated and extended this structure, expanding Resilience Resources into 7 domains (adding Purpose and Prosociality, Physical Activity, Dietary Intake, and Perseverative Thinking). Confirmatory factor analyses supported a 2-domain structure, comprising a higher-order Stress Load factor with 3 subdomains (Work Stress, Personal Stress, and Burnout) and a higher-order Resilience Resources factor with 7 subdomains (Emotion Regulation and Coping, Social Connectedness, Purpose and Prosociality, Sleep, Physical Activity, Dietary Intake, and Perseverative Thinking). The Stress Load model demonstrated excellent fit (χ²33=64.18; P=.01; CFI=0.99; TLI=0.98; RMSEA=0.06; and standardized root mean square residual=0.05), and the Resilience Resources model also fit well (χ²443=745.20, P<.001; CFI=0.94; TLI=0.94; RMSEA=0.05; and standardized root mean square residual=0.06). All subscales showed strong internal consistency (composite reliability: mean 0.84, SD 0.10; range 0.74‐0.93) and excellent test-retest reliability over 3 weeks (intraclass correlation coefficients 0.77‐0.90, 95% CI 0.87-0.93). The index showed strong convergent validity (r=0.73 with Connor-Davidson Resilience Scale and r=–0.66 with Perceived Stress Scale-4) and explained additional variance beyond established measures in predicting depression, anxiety, and well-being (ΔR²=0.07‐0.11; P<.001).ConclusionsThe WONE Index provides a psychometrically robust tool for assessing stress resilience capacity in working adults. Its integrated structure captures dynamic relationships between stress exposure and resilience resources, thereby supporting personalized intervention delivery in digital health platforms and organizational well-being programs.

AimTo assess validity and reliability of the German version of the Individualized Care Scale (ICS).BackgroundIndividualized nursing care plays a pivotal role in establishing patient-centered care. To assess individualized nursing care and to compare it in different settings and countries, valid and reliable instruments are needed. No psychometric-tested instrument for comparing individualized nursing care with other countries is available in Germany.DesignCross-sectional study.MethodsData were collected between September 2013 and June 2014 from 606 patients in 20 wards in five hospitals across Germany. Unidimensionality of the ICS scales ICSA (patients’ views on how individuality is supported through nursing interventions) and ICSB (patients’ perceptions of individualized nursing care) was analyzed by confirmatory factor analysis. Internal consistency was assessed by calculating Cronbach’s alpha. The Smoliner Scale (patients’ perceptions of the decision-making process in nursing care) and results from participating hospitals’ assessment of the nursing care delivery systems were used to assess known-groups validity and concurrent validity.ResultsFit indices of confirmatory factor analysis indicate unidimensionality of the ICSA (Comparative Fit Index: 0.92; Tucker-Lewis Index: 0.902; root mean square error of approximation: 0.09; standardized root mean square residual: 0.05) and the ICSB (Comparative Fit Index: 0.91; Tucker-Lewis Index: 0.89; root mean square error of approximation: 0.09; standardized root mean square residual: 0.05). Internal consistency using Cronbach’s alpha was 0.95 (95% confidence interval: 0.94–0.95) for ICSA and 0.93 (95% confidence interval: 0.92–0.94) for the ICSB. Concurrent validity was established by a significant relationship between the Smoliner Scale and ICSA (r=0.66; P<0.01) and ICSB (r=0.72; P<0.01). Known-groups validity was approved by ICSA/ICSB score differences related to nursing care delivery systems and patients’ perceptions of decision-making style.ConclusionThe German version of the ICS is deemed a valid and reliable instrument for use in practice and research with hospitalized patients.

The Double-Edged Sword Effects of Career Calling on Occupational Embeddedness: Mediating Roles of Work–Family Conflict and Career Adaptability

Arabic validation of a cyberbullying assessment instrument

The Brazilian Portuguese Version of the Measure of Intermittent and Constant Osteoarthritis Pain for Individuals With Hip Osteoarthritis: Translation, Cross-Cultural Adaptation, and Measurement Properties.

The Patient Specific Functional Scale - Brazil as an instrument for the functional assessment of patients with chronic non-specific low back pain: Construct validity (hypothesis testing and structural validity) and test-retest reliability

AimTo translate, culturally adapt, and psychometrically validate the Japanese version of the Death Literacy Index (DLI‐J) and its short‐form version (DLI‐J‐9) to assess death literacy among Japanese adults.MethodsA multiphase mixed‐methods design was employed. The process included forward translation, reconciled single translation, back translation, translation review, cognitive interviews (n = 8), and psychometric validation using a nationally representative online sample of 2500 Japanese adults aged 20–79 years. Participants completed an online survey, with a subsample (n = 300) completing a retest after 4 weeks. Confirmatory factor analysis (CFA), internal consistency, construct validity, and test–retest reliability were evaluated.ResultsThe DLI‐J demonstrated excellent psychometric properties. CFA supported the six‐factor structure of the DLI‐J (Tucker–Lewis index [TLI] = 0.940, comparative fit index [CFI] = 0.947, standardized root mean square residual [SRMR] = 0.048, and root mean square error of approximation [RMSEA] = 0.063) and the two‐factor structure of the DLI‐J‐9 (TLI = 0.945, CFI = 0.960, SRMR = 0.042, and RMSEA = 0.069). Internal consistency was excellent for the total DLI‐J scale (α = 0.959) and all subscales (α = 0.870–0.959). Convergent validity was supported by positive correlations with death competency, whereas discriminant validity was confirmed by negligible correlations with loneliness. Known‐groups validity was established, with higher scores among bereaved individuals and end‐of‐life care professionals. The test–retest reliability was moderate to good (intraclass correlation coefficient [ICC] = 0.515–0.819). The overall DLI‐J mean score was 3.82 (standard deviation = 1.91), lower than international benchmarks. Floor effects were observed in the hands‐on care, accessing help, and community support subscales.ConclusionThe DLI‐J and DLI‐J‐9 are psychometrically robust instruments for assessing death literacy.

Purpose: This study aimed to culturally adapt and validate the Canadian Assessment of Physical Literacy for use with Polish children aged 8–12 years. Method: The Canadian Assessment of Physical Literacy questionnaire was translated into Polish and adapted using the method of forward and back translation. The internal consistency, reliability, and construct validity were examined ( n = 781). Results: The motivation and confidence domain demonstrated excellent internal consistency (α = .876) and test–retest reliability (intraclass correlation coefficient = .905), while the knowledge and understanding domain showed moderate reliability (α = .70; intraclass correlation coefficient = .714). Confirmatory factor analysis results, χ 2 (37) = 72.7, p &lt; .001, χ 2 /df = 1.95, comparative-fit index = .982, Tucker–Lewis index = .973, root mean square error of approximation = .031, standardized root mean square residual = .024, supported the four-domain model as a good fit for the data. Discussion/Conclusion: Overall, the findings confirm that this Polish version of Canadian Assessment of Physical Literacy is a reliable and valid tool for assessing physical literacy among Polish children across all four domains.

BackgroundThe Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population.MethodsHealthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test–retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI.ResultsWe identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953–0.989, Tucker–Lewis index = 0.931–0.984, root means square error of approximation = 0.040–0.092, standardized root mean square residual = 0.039–0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach’s alpha = 0.811–0.835, McDonald’s omega = 0.805–0.832), and test–retest reliability (intraclass correlation coefficient = 0.829).ConclusionThe SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.

Context: To date, no questionnaire is available to measure the impact of piles on quality of life (QoL). Aims: We aimed to develop so and examine its cross-cultural adaptability considering linguistic equivalence. Study Design: A mixed method approach was taken. The Anorectal Symptom Severity and Quality of Life (ARSSQoL) Questionnaire English version was developed through Delphi technique initially. The questionnaire consisted of 16 items. Subsequently, the Hindi version was produced by standardized forward– backward translations. The psychometric properties were tested after gathering responses through a cross-sectional study at State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh. Patients and Methods: Data were obtained from 258 patients suffering from piles through consecutive sampling. Statistical Analysis: Psychometric analysis was run to examine its factor structure, validity, and reliability. Construct validity was examined by exploratory factor analysis (n = 129) using principal component analysis (varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 129) was performed to verify model fit. Reliability was examined using internal consistency (n = 258). Results: The overall internal consistency was excellent (Cronbach’s a and intra-class correlation coefficient: 0.823; 95% confidence interval: 0.790–0.853). Concurrent, convergent, and discriminant validity was acceptable. Test–retest reliability (P &gt; 0.05) was satisfactory. The Kaiser–Meyer–Olkin (0.790) and Bartlett’s test of sphericity (Chi-square = 644.228, P &lt; 0.001) suggested sample adequacy. In factor analysis, all the items loaded above the prespecified value of 0.4 and identified three components (psychological impact, symptom severity, and concern) and two isolated items (bleeding per rectum and itching in anus) explaining 63% of variation. The goodness of fit in CFA model was acceptable (Chi-square: 163.201, P &lt; 0.001; comparative fit index = 0.806, Tucker–Lewis index = 0.762, root mean square error of approximation = 0.097, standardized root mean square residual = 0.106). Conclusions: The ARSSQoL Hindi consisting of 16 items and framed within 3 components and 2 isolated items appeared as a valid and reliable instrument for measuring the impact of piles on QoL. Translation into other languages, cross-cultural adaptation, and formal validation are warranted.

Psychometric Analyses of the Eating and Food Literacy Behaviors Questionnaire with University Students

Background: A comprehensive understanding of chronic pain is crucial for assessing its impact on knee osteoarthritis (KOA). This study aimed to translate, cross-culturally adapt, and validate the ICOAP into Brazilian Portuguese for individuals with KOA. Methods: A total of 133 individuals with KOA participated. Phase 1 involved the translation and cross-cultural adaptation of the ICOAP into Brazilian Portuguese. In Phase 2, the pre-final version was tested, and in Phase 3, the final version was validated with 103 participants. Convergent validity was assessed using Spearman's correlation with the Numeric Rating Pain Scale (NRPS), the International Knee Documentation Committee (IKDC), and the Short Form 36 Health Survey (SF-36). Internal structure was evaluated through exploratory and confirmatory factor analyses using fit indices: chi-square/degrees of freedom (χ2/df), root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), comparative fit index (CFI), and Tucker-Lewis index (TLI). Internal consistency was assessed with Cronbach's alpha (α), and floor and ceiling effects were examined. A subsample of 53 participants was used to assess test-retest reliability through the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC). Results: The ICOAP showed adequate fit indices. Reliability analysis demonstrated satisfactory internal consistency and test-retest reliability. However, only the constant pain domain exhibited convergent validity. Conclusions: The Brazilian Portuguese version of the ICOAP consists of two independent domains with good internal consistency and reliability. However, only the constant pain domain showed appropriate convergent validity.