Psychometric evaluation of the Chinese version of the shortened version of the RFL-OA scale (SRFL-OA)

To compare two methods of calculating interrater agreement while determining content validity of the Paediatric Pain Knowledge and Attitudes Questionnaire for use with Australian nurses. Paediatric pain assessment and management documentation was found to be suboptimal revealing a need to assess paediatric nurses' knowledge and attitude to pain. The Paediatric Pain Knowledge and Attitudes Questionnaire was selected as it had been reported as valid and reliable in the United Kingdom with student nurses. The questionnaire required content validity determination prior to use in the Australian context. A two phase process of expert review. Ten paediatric nurses completed a relevancy rating of all 68 questionnaire items. In phase two, five pain experts reviewed the items of the questionnaire that scored an unacceptable item level content validity. Item and scale level content validity indices and intraclass correlation coefficients were calculated. In phase one, 31 items received an item level content validity index <0·78 and the scale level content validity index average was 0·80 which were below levels required for acceptable validity. The intraclass correlation coefficient was 0·47. In phase two, 10 items were amended and four items deleted. The revised questionnaire provided a scale level content validity index average >0·90 and an intraclass correlation coefficient of 0·94 demonstrating excellent agreement between raters therefore acceptable content validity. Equivalent outcomes were achieved using the content validity index and the intraclass correlation coefficient. To assess content validity the content validity index has the advantage of providing an item level score and is a simple calculation. The intraclass correlation coefficient requires statistical knowledge, or support, and has the advantage of accounting for the possibility of chance agreement.

To develop a Chinese version of the Stress Adaption Scale (SAS) and to assess its reliability and validity among Chinese patients with multimorbidity. The Brislin model was used to translate, synthesize, back-translate, and cross culturally adapt the SAS. A total of 323 multimorbidity patients selected by convenience sampling method from four hospitals in Zhejiang province. The critical ratio method, total question correlation method, and graded response model (item characteristic curve and item discrimination) were used for item analysis. Cronbach's alpha coefficient and split-half reliability were used for the reliability analysis. Content validity analysis, structural validity analysis, and criterion association validity analysis were performed by expert scoring method, confirmatory factor analysis, and Pearson correlation coefficient method, respectively. The Chinese version of the SAS contained 2 dimensions of resilience and thriving, with a total of 10 items. In the item analysis, the critical ratio method showed that the critical ratio of all items was greater than 3.0 (P<0.001); the correlation coefficient method showed that the Pearson correlation coefficients for all items exceeded 0.4 (P<0.01). The graded response model showed that items of the revised scale exhibited distinct item characteristic curves and all items had discrimination parameters exceeding 1.0. In the reliability analysis, Cronbach's alpha coefficient of the revised Chinese version of the SAS scale was 0.849, and the split-half reliability was 0.873. In the validity analysis, the item-level content validity index and scale-level content validity index both exceeded 0.80. In the confirmatory factor analysis, the revised two-factor model showed satisfactory fit indices (χ2/df=3.115, RMSEA=0.081, RMR=0.046, GFI=0.937, AGFI=0.898, CFI=0.936, TLI=0.915). In the criterion-related validity analysis, the Chinese version of the SAS score was negatively correlated with the Perceived Stress Scale and the Treatment Burden Questionnaire, with correlation coefficients of －0.592 and －0.482, respectively (both P<0.01). The Chinese version of the SAS has good reliability and validity, which can be used to evaluate the stress adaption capacity among multimorbidity patients in China, and provides a reference for developing individualized health management measures.

This paper aims to assess entrepreneurial behavior among vocational college students in China with a valid measurement, the content validity index (CVI). Content validity is essential for substantiating the accuracy of an assessment tool such as questionnaires, particularly in the context of research. In this process, content validity was ensured through use of an expert panel approach comprising five individuals with expertise in the studied field. Therefore, vocational college students’ entrepreneurial behavior, which consists of entrepreneurial activities, overcoming failure, and proactive behavior, was analyzed and tested using CVI. This research included five expert panels in the field of entrepreneurial education in China, and a 4-point relevance rating scale that has already been proven to have high efficacy was used in this study. There are two types of CVIs, the Scale-level Content Validity Index (S-CVI) and the Item-level Content Validity Index (I-CVI). Items scoring less than 1.00 on the I-CVI or less than 0.9 on the S-CVI were removed. The researcher found that the constructs of entrepreneurial behavior, including entrepreneurial activities, overcoming failure, and proactive behavior, demonstrated strong content validity in assessing the extent of entrepreneurial behavior among vocational college students in China. After this stage, further research on construct validity and reliability tests with the current scale is recommended. The results further confirm its suitability, indicating that this scale is applicable for researchers exploring studies that focus on entrepreneurial behavior within the context of vocational colleges.

This paper aims to assess teacher innovativeness among Henan private universities in China with a valid measurement, the content validity index (CVI). Content validity is essential for substantiating the accuracy of an assessment tool such as questionnaires, particularly in the context of research. In this process, content validity was ensured through use of an expert panel approach comprising five individuals with expertise in the studied field. Therefore, teacher innovativeness in private universities, which consists of openness to change, creativity, risk-taking propensity, and flexibility to educational changes, was analyzed and tested using CVI. This research included five expert panels in the field of educational management in China and a 4-point relevance rating scale that has already been proven to have high efficacy was used in this study. There are two types of CVIs: the Scale-level Content Validity Index (S-CVI) and the item-level Content Validity Index (I-CVI). Items scoring less than 1.00 on the I-CVI or less than 0.9 on the S-CVI were removed. The researcher found that the constructs of teacher innovativeness, including openness to change, creativity, risk-taking propensity, and flexibility, demonstrated strong content validity in assessing the extent of teacher innovativeness among Henan private universities in China. After this stage, further research on construct validity and reliability tests with the current scale is recommended. The results further confirm its suitability, indicating that this scale is applicable for researchers exploring studies that focus on teacher innovativeness within the context of private universities.

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.

BackgroundIn light of the global challenges posed by an ageing population, the evaluation of long-term care (LTC) is of particular importance. The Adult Social Care Outcomes Toolkit Four-Level Self-completion Tool (ASCOT-SCT4) is a preference-based instrument developed to measure long-term care (LTC) related quality of life (QoL). However, it is not yet available in Hong Kong (HK). This study aims to translate and culturally adapt the ASCOT-SCT4 into Chinese and evaluate its content validity in the HK context.MethodsThe study adhered to well-established international guidelines for conducting translation, cultural adaptation, and content validation of instruments. The translation process included forward, backward translations, and expert committee review. Subsequently, LTC users aged 60 or above and experts with diverse professional backgrounds in LTC were involved in content validation in terms of comprehensibility, relevance, and comprehensiveness through cognitive interviews and a content validity index (CVI) survey. For clarity and relevance, an item-level CVI (I-CVI) of ≥ 0.78 and a scale-level CVI (S-CVI) of ≥ 0.90 were considered acceptable.ResultsIn the translation process, concern was raised about the literal translation of ‘Control over daily life’ item. During the cognitive interviews, 27 LTC users perceived the instrument’s length as acceptable, and experienced no sensitive feelings while completing it. However, seven of the nine items were found to have comprehension and interpretation issues, which were mostly resolved through revisions of wordings. For the ‘Food and drink’ and ‘Dignity’ items, alternative terms were used and sentence structure was revised to improve its comprehensibility while ensuring equivalence to the original English version. The final translated version demonstrated acceptable clarity (S-CVI: 0.92, I-CVIs: 0.86–1.00) as evaluated by seven experts. Both LTC users and experts found the items relevant (S-CVI: 0.97, I-CVIs: 0.94 to 1.00), and no additional LTC-related QoL domains were identified as missing from the instrument.ConclusionsThis study provides evidence that the Chinese version of the ASCOT-SCT4 is comprehensible, relevant, and comprehensive for the HK context, which allows for further testing on psychometric properties in a larger population.

To effectively mitigate the health impacts of climate change, future nurses must be equipped with the requisite knowledge and competencies. Knowing their levels of eco-literacy would help to make them more effective. Background/Objectives: This descriptive study will use a three-round, multicentre, modified e-Delphi survey to establish an expert panel's consensus on the Climate, Health, and Nursing Tool's (CHANT) item-level and scale-level content validity indices. It will also examine potential associations between the expert panel members' sociodemographic and professional characteristics and their content validity index assessments of the CHANT. Methods: The study will be conducted in the French-speaking regions of Switzerland, running its three-round e-Delphi survey between January and April 2025. After each round, the CHANT's overall scale-level and individual item-level content validity indices will be computed. Comparisons between different types of healthcare professionals' profiles will also be conducted. Results: The three-round modified e-Delphi survey should allow the expert panel to reach a consensus on the CHANT's overall content validity index. The tool should then be considered suitable for pilot testing. The first round brought together 16 experts from different regions, namely French-speaking Switzerland, France, and Belgium. Conclusions: To ensure that the nursing discipline is well positioned to meet future challenges, the development of eco-literacy must be integrated into nursing education. Ensuring the CHANT's conceptual and psychometric validity will be essential in strengthening nursing competencies in and knowledge about planetary health and in implementing future educational interventions.

Preventing skin tears (STs) in older adults is an urgent public health concern, especially in long-term care (LTC) facilities. However, limited research on ST prevention among care workers exists due to a lack of suitable assessment tools. This study aims to develop and psychometrically evaluate the Knowledge, Attitude and Practice instrument for care workers in preventing Skin Tears (KAP-ST) in older adults. The KAP-ST was developed and validated in four phases during May-October 2024. First, an item pool was generated through a comprehensive literature review. Second, a preliminary instrument was developed through a Delphi expert consultation and pilot testing. Third, the items and the final instrument were optimised through a cross-sectional survey involving 317 care workers from 29 LTC facilities in China. Finally, a psychometric evaluation was conducted in another cross-sectional survey involving 373 care workers from 18 LTC facilities. The final KAP-ST contains 35 items across knowledge, attitude and practice dimensions. Exploratory factor analysis (EFA) revealed a nine-factor structure (factor loadings ranging from 0.451 to 0.799, accounting for 61.35% of total variance). The Item-Level Content Validity Index (I-CVI) values ranged from 0.926 to 1.000, and the Scale-Level Content Validity Index (S-CVI/Ave) was 0.991. The instrument's Cronbach's α, split-half, and test-retest reliability coefficients were 0.887, 0.744, and 0.934, respectively. The CFA analysis revealed an ideal absolute fit validity (RMSEA = 0.068; RMR = 0.029) and parsimony fit validity (PGFI = 0.684). The KAP-ST demonstrates strong reliability, structural validity and content validity. It is well-suited for assessing care workers' knowledge, attitudes and practices in preventing STs among older adults. Further research is required to enhance and confirm its validity. STs in the spotlight recently necessitate the use of appropriate investigative tools to facilitate in-depth research, especially for care workers, who should prioritise access to specialised knowledge. Introducing professional guidance in LTC facilities is recommended to enhance the knowledge, attitude and practice of care workers. Standardised Guidelines for Scale Construction and COSMIN checklist. No patient or public contributions.

This study assessed the initial psychometric properties of a novel in-home, performance-based instrument for older adults called the In-Home Medication Management Performance Evaluation (HOME-Rx). Content validity of the HOME-Rx was determined through the multistep content validity index (CVI) process. Content experts provided qualitative and quantitative judgment of the instrument's ability to measure medication management. The assessment's target population provided qualitative feedback. CVI outcomes informed instrument revisions. Content experts (n = 7) were in agreement that the overall instrument was valid for measuring medication management (scale-level CVI = .95). Six items were deleted because of low agreement (item-level CVI <.80). Twenty-nine minor edits were made to the order of questions and language. Older adult participants (n = 5) reported the instrument was relevant, acceptable, and easy to understand. The HOME-Rx appears to be a relevant and valid method to assess performance barriers to medication management in the home.

Background Persons with aphasia (PWA) often experience difficulties in functional communication (i.e. the ability to use language effectively in real-world contexts), primarily due to their linguistic impairments. Given the growing emphasis on functional communication assessment in clinical practice and research, and the fact that most available tools are developed in English, there is a need to adapt and validate such tools for individuals who speak languages other than English. Aim The aim of this study was to translate and adapt communication effectiveness index (CETI) into Malayalam, a South Indian language, and examine its psychometric properties. Methods & Procedures The study included a total of 70 participants (n = 70), comprising 35 PWA and their 35 primary caregivers. CETI was adapted to Malayalam by following standard procedures for cross-cultural adaptation. Item level and scale level content validity index (i.e. I-CVI and S-CVI) were calculated with ratings obtained by 8 SLPs and 5 laypersons. Construct validity was measured by comparing overall CETI scores with that of the aphasia quotient (AQ) scores obtained on Test of Aphasia in Malayalam. The adapted tool was administered on the primary caregivers to calculate internal consistency. Test-retest reliability was measured by re-administering the tool in 15% of the caregivers after a two-four-week interval. Outcomes & Results The CETI-Malayalam exhibited strong psychometric properties. Content validity was supported by individual item content validity index (I-CVI) values exceeding 0.93 and a scale-level content validity index (S-CVI) greater than 0.98 for relevance and clarity. Construct validity was demonstrated by a significant positive correlation (r = 0.915) between CETI and AQ scores. Internal consistency was excellent, with Cronbach’s alpha (α) of 0.98 and split-half reliability of 0.96. Intraclass correlation coefficient (ICC) was 0.99, suggesting high test-retest reliability. Conclusion The CETI-Malayalam is a reliable and valid tool for evaluating functional communication skills of Malayalam-speaking PWA.

The Food Neophobia Scale (FNS) is a research instrument, originally developed in English, to assess an individual's level of food neophobia. However, it has not yet been translated and validated for Malaysians. Therefore, we aimed to translate and validate a Malay-translated version of the FNS. Respondents were 200 young adults (mostly females, 73%; and students, 82.0%; M age = 22.3years, SD = 2.3). We first translated the FNS into Malay using the forward-backward translation method, and a panel of nutrition and dietetics experts then reviewed it for item relevance, clarity, simplicity, and ambiguity. The translated FNS suggested good content validity with an item-level content validity index (I-CVI) > .8, a scale-level content validity index (S-CVI)/average = .8 and a S-CVI/universal agreement = .96. Principal component analysis revealed a two-factor model: (i) willingness and trust; and (ii) rejection and fear. Cronbach's alpha for the Malay-translated FNS was .808, demonstrating high internal consistency and reliability among young Malaysian adults. Future investigators can now use this Malay-translated FNS instrument to determine levels of food neophobia among Malaysians.

Understanding how cardiovascular structure and physiology guide management is critically important in paediatric cardiology. However, few validated educational tools are available to assess trainee knowledge. To address this deficit, paediatric cardiologists and fellows from four institutions collaborated to develop a multimedia assessment tool for use with medical students and paediatric residents. This tool was developed in support of a novel 3-dimensional virtual reality curriculum created by our group. Educational domains were identified, and questions were iteratively developed by a group of clinicians from multiple centres to assess understanding of key concepts. To evaluate content validity, content experts completed the assessment and reviewed items, rating item relevance to educational domains using a 4-point Likert scale. An item-level content validity index was calculated for each question, and a scale-level content validity index was calculated for the assessment tool, with scores of ≥0.78 and ≥0.90, respectively, representing excellent content validity. The mean content expert assessment score was 92% (range 88-97%). Two questions yielded ≤50% correct content expert answers. The item-level content validity index for 29 out of 32 questions was ≥0.78, and the scale-level content validity index was 0.92. Qualitative feedback included suggestions for future improvement. Questions with ≤50% content expert agreement and item-level content validity index scores <0.78 were removed, yielding a 27-question assessment tool. We describe a multi-centre effort to create and validate a multimedia assessment tool which may be implemented within paediatric trainee cardiology curricula. Future efforts may focus on content refinement and expansion to include additional educational domains.

Background: The coverage of immunization amongst adults in India remains low; a lack of nationally endorsed guidelines and implementation policies is a contributing factor. There is a paucity of tools available to assess knowledge, attitude, and practices (KAP) regarding adult immunization. Hence, we attempted to develop a KAP questionnaire to evaluate the existing expertise regarding adult immunization among medicine and infectious diseases resident doctors in an apex medical institute in India. Methods: A two-stage scheme for the development and validation of the questionnaire was followed. The first step involved an exhaustive literature review, focused group discussion, and in-depth interviews. The prepared draft was reviewed by experts in the field of infectious diseases and adult immunization across the domains of necessity, relevance, and clarity. ‘Item-level content validity indices’ (I-CVI) and ‘Scale-level content validity indices’ (S-CVI) were then calculated. Brennan and Prediger's AC (Agreement Coefficient) and Gwet’s AC (Agreement Coefficient) were used to establish inter-rater agreement on the obtained expert reviews. Results: A 57-item KAP questionnaire was developed and was reviewed by a total of 11 experts. The questionnaire had satisfactory I-CVI (&gt;0.6 for all the items) and S-CVI Ave (&gt;0.9 for each of the domains). The questionnaire had a strong inter-rater agreement as assessed by both Brennan and Prediger AC (&gt; 0.6, p&lt;1) and Gwet’s AC (&gt;0.8, p&lt;1). Conclusions: The developed tool was scientifically validated following a staged process. We propose that this questionnaire can hence be used to evaluate the knowledge, attitude, and practices regarding adult immunization amongst medical practitioners across medical colleges and hospitals in India. This may be instrumental in developing programmatic interventions and major policy changes to enhance the practice of adult immunization amongst healthcare providers.

BACKGROUND: In the last few decades, the revised diagnostic criteria for multiple sclerosis (MS) and the development of numerous new MS therapies have created the possibility of early diagnosis and opportune MS management. However, these changes, and the mounting emphasis on patient choice and shared decision making, have not been accompanied by improvements in information provided to patients with MS (PwMS). Information provision for PwMS increases disease-related knowledge that may assist them in decision making and quality of life. The purpose of this study was to validate the Multiple Sclerosis and Magnetic Resonance Imaging Knowledge Questionnaire (MSMRIKQ) to improve patients' shared decision-making capabilities. METHODS: In this methodological study, the instrument development process was completed in 4 stages using principles of measurement theory: (1) establishing a pool of items after patient and clinician panels' review, (2) evaluating the validity of the scale-both face and content validity, (3) pilot testing the scale, and (4) post-pilot testing statistical analysis of items and scale reliability and validity. RESULTS: The 20-item instrument was finalized based on a panel of MS experts' and patients' comments. The final version of the MSMRIKQ was pilot tested with a sample of 46 PwMS. Face validity was established on all MSMRIKQ items. Individual item-level and scale-level content validity indices for universal agreement estimates were acceptable at item-level content validity index = 1 and scale-level content validity index = 1 for the 20 items. The Kuder-Richardson 20 reliability estimate for the entire scale was 0.58; the Kuder-Richardson 20 estimates for the subscales of MS and magnetic resonance imaging knowledge were 0.35 and 0.51, respectively. The split-half reliability with Spearman-Brown correction for the total scale was 0.60. The Poisson regression model was significant for predicting MS knowledge within this population. CONCLUSION: The MSMRIKQ is a basic knowledge instrument for clinical and research use.

Measuring the role of fathers on breastfeeding success: Psychometric properties of Ethiopia's Afaan Oromo version of the partner breastfeeding influence scale.