3-factor Model Research Articles

Acceptance and Use of eHealth in Support and Psychological Therapy for People With Intellectual Disabilities: Two Cross-Sectional Studies of Health Care Professionals

Background Acceptance of health care professionals is of paramount importance for the uptake and implementation of eHealth. The Unified Theory of Acceptance and Use of Technology (UTAUT) model is a widely used framework for studying health care professionals’ acceptance and actual use of eHealth among general client populations. However, there is limited understanding of the eHealth acceptance of health care professionals working with people with intellectual disabilities (ID). Objective This study aimed to explore the applicability of the UTAUT model toward understanding the acceptance, intention to use, and actual use of eHealth among support staff and therapists working with people with ID. Methods A total of 2 cross-sectional survey studies were conducted among health care professionals from 5 health care organizations for people with ID in the Netherlands in 2018 (n=311) and in 2021 during the COVID-19 pandemic (n=326). In addition to confirmatory and exploratory factor analyses to evaluate both the original UTAUT model and an extended version, descriptive analysis was used to explore participants’ characteristics, acceptance levels, and eHealth usage. Moderator analysis and multiple regression analysis were also used. Results A confirmatory factor analysis indicated a poor fit for both the original 4-factor UTAUT model and the extended version. An exploratory factor analysis was then conducted, resulting in a more satisfactory 5-factor model after removing 1 item with a factor loading <.40. Internal consistency of the 5 factors ranged from acceptable to good (Cronbach α=.76-.85). Collectively, all factors predicted the intention to use eHealth in 2018 (R2=0.47; F5,305=54.885; P<.001) and in 2021 (R2=0.43; F5,320=49.32; P<.001). Participants scored moderately on all 5 acceptance factors in both 2018 and 2021. Moderator analysis indicated that age and voluntariness influence the relationship between factors that determined acceptance and intention to use eHealth. Conclusions The findings from 2 cross-sectional studies conducted in 2018 and 2021, using an extended UTAUT model, gave a deeper understanding of eHealth acceptance among health care professionals who work with people with ID.

Validation of the Brief Index of Sexual Functioning for women and men (BISF-W and BISF-M) in an Italian sample

IntroductionThe Brief Index of Sexual Functioning for Women (BISF-W) is an international 4-factors tool assessing qualitative and quantitative aspects of sexual experiences in women, both in clinical and experimental settings. The present research aims at validating an Italian version of the BISF-W, to develop a BISF version for men (BISF-M) to fill the gap in the existing sexual function evaluation tools in Italy and to analyze gender and age groups differences in the BISF factors.MethodsThe research included 6,355 women, aged from 18 to 65 (M = 34.94, SD = 10.52) and 2,207 men, aged from 18 to 80 (M = 38.25, SD = 13.67), who completed the BISF-W and BISF-M. The Quality of Marriage Index (QMI) was administrated to both samples for testing divergent validity, while Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were administered for testing convergent validity. Correlation analysis, MANOVA between gender and age and Confirmatory Factor Analysis were conducted.ResultsThe CFAs confirmed that the proposed 4-factor model (Dyadic, Solitaire and Anal Sexuality, and Sexual Difficulties) is suitable both for the BISF-W and the BISF-M, demonstrated strong psychometric properties for assessing sexual functioning in both genders, with dyadic sexuality being the most important factor. MANOVA analysis showed significative differences in the factors’ scores, according to gender and age.DiscussionThe BISF-W and the BISF-M are promising tools to address sexual functioning in individuals and couples, both in clinical and non-clinical settings. Gender and age differences are discussed regarding the potential use of BISF in the therapeutic context.

Design, validation and psychometric properties of a questionnaire to assess intrapreneurial behaviours in sports organisations

Intrapreneurs in sports organisations can detect early signs of new opportunities and threats and introduce early changes to adapt to the constant changes in the sports sector. In addition, intrapreneurs are considered a fundamental pillar in the growth and development of innovation in sports organisations. Thus, the objective of this work is to design and validate an instrument to detect employees with intrapreneurial behaviours in sports organisations. Based on the dimensions of intrapreneurship identified in the scientific literature and related questionnaires, a tool—the COINDE—composed of 46 items distributed in five dimensions was constructed and subjected to expert judgment and a pilot study and subsequently reduced to 26 items and five statistically validated dimensions. Exploratory factor analysis (EFA) yielded two valid and reliable models to detect employees with intrapreneurial behaviours in sports organisations, with 5 and 6 dimensions and 25 and 26 items, respectively. The 5-factor model is proposed and justified. The dimensions are: creativity/innovation, risk-taking, proactivity, recognition of opportunities and priority of the internal project. The COINDE is a valid and reliable instrument representing an important advance over the existing instruments by providing specificity of the measure in the sports context, the work profile of the employees of these organisations, and allowing direct evaluation of intrapreneurial behaviour.

Self-care practices of foundation year doctors in Malta.

Several studies have shown high rates of mental health problems amongst doctors in training worldwide. Self-care has been shown to be protective against burnout and increases subjective wellbeing. This study aims to investigate the self-care practices of foundation year doctors (FYs) in Malta. All doctors enrolled in Foundation Programme Malta in 2022 were invited to participate in an online questionnaire containing the Mindful Self-Care Scale (MSCS). Confirmatory factor analysis confirmed the 6-factor model described in literature. The independent sample t-test and Mann-Whitney U-test were used to check for relationships between total scores and variables of interest and means and medians for each group were compared. A total of 122 doctors answered the questionnaire out of 264 (46%). The median score for our FY cohort was 68, indicating moderate levels of self-care. Almost 40% of participants rarely or never experienced a sense of meaning at work. Working for long hours under stressful conditions means that self-care must be one of the top priorities for new doctors. However, very few FYs working in Malta regularly care for their physical and mental health. Strategies to improve trainee wellbeing must first focus on systemic factors to allow the individual factors to be addressed.

(A)voiding misdiagnosis: prediction of detrusor underactivity vs. bladder outlet obstruction using pre-urodynamic nomogram in male patients with LUTS.

Our study aimed to develop a noninvasive model using a combination of the set of clinical data and uroflowmetry (UFL) to differentiate between detrusor underactivity (DU) and bladder outlet obstruction (BOO) in non-neurogenic male patients with lower urinary tract symptoms (LUTS). Data from 229 men with LUTS, diagnosed with DU or BOO on a pressure-flow study (PFS), were retrospectively analyzed, including medical history, Core Lower Urinary Tract Symptoms score (CLSS) questionnaire, UFL and PFS. Uni- and multivariate logistic regression were utilized for the prediction analyses. Of the cohort, 128 (55.9%) patients were diagnosed with DU. A multivariate logistic regression analysis identified less prevalent nocturia (OR 0.27, p < 0.002), more prevalent intermittency (OR 2.33, p = 0.03), less prevalent weak stream (OR 0.14, p = 0.0004), lower straining points in CLSS (OR 0.67, p = 0.02), higher slow stream points in CLSS (OR 1.81, p = 0.002), higher incomplete emptying points in CLSS (OR 1.31, p < 0.02), lower PVR ratio (OR 0.20, p = 0.03), and present features of fluctuating (OR 2.00, p = 0.05), fluctuating-intermittent (OR 3.09, p < 0.006), and intermittent (OR 8.11, p = 0.076) UFL curve shapes as independent predictors of DU. The above prediction model demonstrated satisfactory accuracy (c-index of 0.783). Our 10-factor model provides a noninvasive approach to differentiate DU from BOO in male patients with non-neurogenic LUTS, offering a valuable alternative to invasive PFS.

Validity of the TGI-SR+ in Francophone populations: Insights from Quebec and Belgium

The loss of a significant person can lead to a broad spectrum of responses. While most individuals gradually recover within a year, a minority develop Prolonged Grief Disorder (PGD). The Traumatic Grief Inventory Self-Report Plus (TGI-SR+) was recently developed to ensure that the original scale (TGI-SR) still accurately assesses PGD in line with the latest diagnostic standards of the DSM-5-TR and ICD-11. This study aimed to validate the TGI-SR+ within two French-speaking cohorts: 276 French-Canadian and 469 Belgian participants. Data were collected through an online survey in 2022. Confirmatory factor analysis resulted in a 4-factor model for the TGI-SR+ total scale, but high inter-item correlations favored a 1-factor solution. A 1-factor model was found for the DSM-5-TR and ICD-11 PGD scores. Convergent validity with mental health disorder, depression, and post-traumatic growth, and known-group validity were confirmed. The findings endorse the TGI-SR+ as a valid tool for detecting potential PGD.

Attitude of adoptive and biological parents to tactile interaction with children

Introduction. The problem of children's adaptation to foster families remains relevant for many years all over the world. However, there is now evidence that humans have two tactile systems, one of which is social and is activated by slow, gentle touch. The idea arose that adoptive parents could be taught such touches using the example of a special massage. But for this you need to know the attitude of parents towards touch in principle. That is why the purpose of this study was to study parents’ attitudes towards tactile interaction with children. Methodology. 277 foster and biological parents (M=39.9; SD=7.6) completed a survey using Google Forms that included 48 statements scored on a psychometric Likert scale. The work used theoretical (analysis, comparison and synthesis), empirical (survey) and statistical (correlation, regression and factor analysis using the SPSS 21 software package) research methods. Results and discussion. Significant inconsistency was found regarding physical sanctions among all groups of respondents. Thus, by unanimously declaring a negative attitude towards punishing the children of other children, respondents allow this to happen to themselves (Ro=-0.603, p&lt;0.001), which affects the personal impact of the child’s development (Ro=-0.508, p&lt;0.001). All mothers reported detecting excessive tactile contact with the child (Ro=0.544, p&lt;0.001). The 4-factor model shows an ambiguous attitude of respondents towards gentle, tactile interaction with both their children and parents in their own childhood (KMO=0.792; p&lt;0.000; 63.1%). Signs of emotional burnout are observed in all parents, but are especially pronounced in adopted ones (p=0.007; R2 =0.056; DW=1.633; r=0.236). Conclusion. Before inviting parents to try massage based on gentle tactile interactions with children, it is necessary to provide training in methods of rewarding and punishing children within the family without violence. A burnout prevention program is needed for all parents.

Psychometric Property of the Japanese Version of Self-Efficacy for Managing Chronic Disease Scale in Individuals with Chronic Diseases

BackgroundAlthough accurately assessing self-efficacy for self-management is crucial in chronic illness care, important, there is a scarcity of validated psychometric properties in Japan. This study aimed to validate a Japanese version of the Self-Efficacy for Managing Chronic Disease (SEMCD-J) scale. MethodsIndividuals with self-reported chronic diseases, symptoms, or conditions for over one year were recruited online. The SEMCD-J was translated through translation, back translation, and cognitive interviews with 15 participants. Patient Health Questionnaire-9 (PHQ-9) and Center for Disease Control and Prevention Healthy Days Core Module-4 (CDC-HRQOL-4) were used to evaluate the scale’s validity. Test-retest reliability was assessed two weeks after the initial measurement. ResultsOf 500 participants, 494 were analyzed and 149 were analyzed for test-retest reliability. The mean item score was 5.54 ± 2.12. Confirmatory factor analysis (CFA) with a 1-factor model showed good fit (CFI = 0.94, TLI = 0.90, RMSEA = 0.23, SRMR = 0.04). CFA with a 2-factor model showed better fit (CFI = 0.99, TLI = 0.98, RMSEA = 0.11, SRMR = 0.01). Cronbach’s α of the total, Factor 1, and Factor 2 were 0.97, 0.97, and 0.92. Their item-total correlations ranged from 0.88 to 0.95, 0.93 to 0.97, and 0.92 to 0.93, respectively. Their interclass correlation coefficients were 0.63, 0.58, and 0.66, respectively. The minimum detectable change was 3.56. Pearson’s correlation analyses indicated that SEMCD-J was significantly associated with PHQ-9 (r = -0.57, p < 0.001) and the dimensions of CDC-HRQOL-4, namely, the degree of general health (r = -0.55, p < 0.001), physically unhealthy days (r = -0.46, p < 0.001), mentally unhealthy days (r = -0.48, p < 0.001), and functionally unhealthy days (r = -0.50, p = < 0.001). ConclusionThe validity and reliability of the SEMCD-J were indicated to be acceptable.

Validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale.

Stigma against people who have alcohol and drug problems severely affects their health and well-being. An instrument based on stigma theory assessing individual-level stigma is essential for a comprehensive understanding of their stigma. We evaluated the validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale (SU-SMS-J) among a population who had alcohol or drug use problems. Adults with experience in substance use disorders from psychiatry outpatient departments and rehabilitation facilities participated in the self-administered questionnaire survey. Confirmatory factor analysis was conducted to test the structural validity of the 5-factor model proposed in other language versions, and factor loadings and correlation between the subscales were confirmed. The correlations between the SU-SMS-J and psychometric properties related to substance use (e.g., severity of substance use, motivation to change) were investigated to assess concurrent validity. Internal consistency was assessed using Cronbach's alpha coefficients. Data from 126 participants were analyzed. The 5-factor model was acceptable with good or reasonable model fit indices. The correlations between subscales were weak to moderate, and this result suggested the SU-SMS-J assessed different but related components of stigma: enacted, anticipated, and internalized stigma from different stigma sources (family and healthcare workers). The SU-SMS-J and subscales showed moderate concurrent validity. Internal consistency was mostly sufficient, with Cronbach's alpha coefficients of 0.86 for all items and 0.66-0.93 for subscales. The SU-SMS-J is valid and reliable for use among populations with substance use problems in various settings in Japan.

Validation of the Internet entrepreneurial self-efficacy scale among Romanian technical students.

This study's aim is to evaluate the Romanian version of the Internet Entrepreneurial Self-Efficacy Scale (IESES), a new assessment scale for online entrepreneurial self-efficacy, and estimate its psychometric properties in a sample of engineering students (N = 644; 317 females). The scale was translated and adapted into Romanian through a forward-backward method. The factorial structure was investigated using Confirmatory Factor Analysis (CFA) and multigroup-CFA for gender invariance. The scale was associated with instruments that measure entrepreneurial intention both traditionally and in the online environment (Individual Entrepreneurial Internet Scale and Entrepreneurial Intention Questionnaire) and components from the Theory of Planned Behavior (attitudes, subjective norms and perceived behavioral control). McDonald's omega and Cronbach's alpha coefficients were used to assess reliability. Traditional statistics are complemented by network analysis. Results show that adequate matching items for the 3-factor model and complete gender invariance is maintained. The three factors are associated with the internet and traditional entrepreneurial intention, and the components from the theory of planned behavior (attitudes, subjective norms, and perceived behavioral control). Internal consistency is excellent because α and ω values range between 0.834 and 0.919. In addition, discriminant validity was demonstrated. The network analysis suggests the relevance of technology utilization in the self-efficacy of online businesses in the case of engineering students. Overall, findings enable us to conclude that the Romanian version of the IESES is a valid, accurate instrument that can be implemented to evaluate self-efficacy related to the successful execution of an online business.

Cross-cultural adaptation and validation of an Urdu version of the Vaccine Attitudes Examination (VAX-U) scale.

Martin and Petrie developed the Vaccine Attitudes Examination (VAX) scale with an aim to document general vaccination attitudes. Vaccine acceptance plays an important role in curbing COVID-19 infections. Thus, it was important to assess vaccination attitudes of Pakistani people towards novel COVID-19 vaccines. The VAX scale was not available in Urdu language for Pakistani population. The study aimed to carry out cross-cultural adaptation and validation of an Urdu version of the Vaccine Attitude Examination (VAX) scale in a selected population sample from Pakistan. A cross sectional study was conducted in September 2021 in an outpatient department of a healthcare facility in Karachi, Pakistan. Adult visitors, eligible for COVID-19 vaccine and spoke Urdu as first language were invited. Convenient sampling was used, and sample size was based on an item response ratio of 1:20. An Urdu version of the VAX scale was developed. The reliability was assessed using Cronbach's alpha (α) and intraclass correlation coefficient (ICC). The model fitness was evaluated using confirmatory factor analysis (CFA) and fit indices namely goodness of fit index (GFI), adjusted goodness of fit index (AGFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA). A structural equation model (SEM) was also developed. IBM SPSS and AMOS were used to analyse the data. The study had ethical clearance. A total of 211 responses were analysed. The reliability (Cronbach's α) was 0.821. The ICC was 0.831 (95% CI: 0.795-0.863). CFA using a 4-factor model revealed the following values for fit indices; GFI = 0.944, AGFI = 0.909, TLI = 0.953, CFI = 0.966, and RMSEA = 0.051. All values reported were in the acceptable range. The VAX Urdu version is a reliable and valid instrument for use in an Urdu speaking population and will enable clinicians to assess the public's attitude towards general vaccination including COVID-19 vaccination. Clinicians can use the VAX-U to document a person's vaccine hesitancy and tailor their counselling to address the issues in vaccine uptake.

The Vaginal Penetration Skills Scale (VPSS): a paradigm shift in genito-pelvic pain/penetration disorder screening, assessment, and stratification.

Receptive vaginal penetration skills have been implicated in the etiology, explanatory models, and treatment of genito-pelvic pain penetration disorder (GPPPD). However, there are no psychometric skills measures designed to screen, assess, and stratify GPPPD. We aimed to develop and psychometrically evaluate a new scale-the Vaginal Penetration Skills Scale (VPSS)-to screen, assess, and stratify GPPPD. This study included 148 Brazilian females with GPPPD symptoms (113 lifelong and 35 acquired) and 251 Brazilian females without sexual complaints. We conducted factor analyses considering all participants (n= 399). Then, we conducted latent class analysis within the GPPPD group to identify clusters of individuals with similar VPSS profiles. We assessed convergent validity through intercorrelation with the Brazilian versions of the Female Genital Self-Image Scale (FGSIS) and the 6-item Female Sexual Function Index (FSFI-6). We developed complete and short-form versions of the VPSS (VPSS-29 and VPSS-SF11, respectively), each with 3 dimensions, to screen, assess, and stratify GPPPD. Factor analysis yielded a 3-factor VPSS model with the "Nonsexual Genital Self-Exploration," "Nonsexual Vaginal Penetration Skills," and "Sexual Vaginal Penetration Skills" dimensions for both VPSS versions. The reliability was excellent for the VPSS-29 (ω= 0.981, α= 0.981) and the VPSS-SF11 (ω= 0.959, α= 0.961). All 3 dimensions could detect significant differences between patients with GPPPD and healthy females. They also differentiated the patients with GPPPD, distinguishing gradient levels. For convergent validity, we found moderate to strong correlations (rho = 0.715-0.745) between the VPSS, FGSIS, and FSFI-6. The VPSS can be applied easily in both clinical and research settings. The VPSS provides a concise and thorough evaluation of receptive vaginal penetration skills in both sexual and nonsexual contexts among patients with GPPPD. The sample had limited diversity regarding gender and sexual orientation; therefore, it is important to validate the use of this scale in populations beyond the cisgender heterosexual female population to ensure its applicability in diverse settings. These results support the reliability and psychometric validity of the VPSS as a self-report measure to screen, assess, and stratify GPPPD symptoms.

Pandemic Palliatives and COVID-19 Coping: Toward the Development of a “Coping with Crisis Communications” (COCCO) Scale

ABSTRACT The COVID-19 pandemic underscored the critical role of coping strategies during global crises and demonstrated how official communications shape public responses. This study evaluates the psychometric validity of a novel pentadic “Coping with Crisis Communication” (COCCO) Scale, which categorizes coping behaviors into five behavioral responses: moving-with, moving-against, moving-outward, moving-away, and moving-inward. A national representative survey of 742 Swiss residents, conducted in February 2022, measured these coping responses to official COVID-19 communications from the Swiss Federal Office of Public Health (FOPH) and traditional Swiss news media (TNM). Items were developed to assess how participants engaged with, opposed, reached outward for support, distanced from, or internalized the messages. Confirmatory factor analyses tested multiple models (5-, 6-, 7-, and 8-factor structures) based on both the initial pentadic theory and data-driven refinements. While the original 5-factor model showed insufficient fit, a 7-factor model (moving-with, moving-toward, moving-against, moving-outward, moving-away, negative-moving-inward, positive-moving-inward) provided a satisfactory factor solution. This model exhibited measurement invariance across the three language versions of the scale (French, Italian, German) and across the two communication contexts (FOPH, TNM). The COCCO scale offers an effective, movement-based assessment of coping strategies in response to crisis communications, serving as a valuable tool for understanding public behavior during global crises.

Validity, Reliability and Psychometric Properties of the Exercise Dependence Questionnaire among Physically Active Young Adults

Background: Exercise Dependence (ED) is characterized by excessive and uncontrollable exercise behaviors leading to physiological and psychological symptoms. Valid assessment tools are crucial for identifying ED in understudied populations. The present study aimed to evaluate the validity and reliability of the Exercise Dependence Questionnaire (EDQ) among physically active young adults in Iran. Methods: This psychometric validation study used a cross-sectional design with 200 participants aged 18-35 years (49% male, 51% female) recruited through clustered random sampling from sports clubs in Tabriz, Iran. The EDQ was administered between May-July, 2021. Validity was assessed through forward backward translation, content validity analysis, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Reliability was evaluated using internal consistency (Cronbach’s alpha) and testretest (intraclass correlation, ICC) methods. Ceiling and floor effects, Standard Error of Measurement (SEM), and smallest detectable change (SDC) were also determined. Results: The EDQ demonstrated good content validity (CVI=0.88, CVR=0.73). EFA yielded a 7-factor model explaining 59.45% of variance. Key factors were withdrawal symptoms, exercise for health/social reasons, positive reward, interference with life, insight into problems, and stereotyped behavior. CFA showed moderate fit. Internal consistency was adequate overall (α=0.8) but lower for some subscales. The ICC confirmed good test-retest reliability (0.80, 95% CI 0.76-0.84). No ceiling and floor effects were detected. SEM and SDC were 0.52 and 1.03, respectively. Conclusion: The results indicated that the Persian version of the EDQ is a valid and reliable scale for assessing ED.

Psychometric properties of the Strengths and Difficulties Questionnaire in an Icelandic community sample

Purpose The current paper aimed to evaluate the psychometric properties of the Icelandic translation of the Strengths and Difficulties Questionnaire, for both parent and teacher reports. SDQ is a widely used questionnaire for screening mental problems among youth. However, only a few studies have conducted a factor analysis on the youngest and oldest cohorts using an adequate sample size. This study aims not only to examine the traditional 5-factor model and alternative models suggested in prior research but also to establish norm data for the Icelandic population. Materials and methods The total sample consists of 1653 youth aged 5–16 years, thereof 316 parent reports and 271 teacher reports for the 5-year-old sample. We used confirmatory factor analysis to evaluate the factor structure. Special attention was given to the models’ performance across different age groups and between genders. This cross-demographic evaluation is vital to ensure that the SDQ’s utility is not limited by developmental or gender-specific variations in symptom expression or reporting. Results We found an acceptable fit for both the original five-factor model and the more recent three-factor model with higher-order internalizing and externalizing factors. The fit for the factor structures seemed to be quite similar across ages. However, we observed goodness-of-fit below the acceptable range for girls on the parent ratings. We also found evidence for the convergent and divergent validity of both models. Conclusions The current study provides further evidence of the utility of the SDQ as a screening instrument, with an acceptable factor structure across ages.

A generalisability theory approach to quantifying changes in psychopathology among ultra-high-risk individuals for psychosis

Distinguishing stable and fluctuating psychopathological features in young individuals at Ultra High Risk (UHR) for psychosis is challenging, but critical for building robust, accurate, early clinical detection and prevention capabilities. Over a 24-month period, 159 UHR individuals were assessed using the Positive and Negative Symptom Scale (PANSS). Generalisability Theory was used to validate the PANSS with this population and to investigate stable and fluctuating features, by estimating the reliability and generalisability of three factor (Positive, Negative, and General) and five factor (Positive, Negative, Cognitive, Depression, and Hostility) symptom models. Acceptable reliability and generalisability of scores across occasions and sample population were demonstrated by the total PANSS scale (Gr = 0.85). Fluctuating symptoms (delusions, hallucinatory behaviour, lack of spontaneity, flow in conversation, emotional withdrawal, and somatic concern) showed high variability over time, with 50–68% of the variance explained by individual transient states. In contrast, more stable symptoms included excitement, poor rapport, anxiety, guilt feeling, uncooperativeness, and poor impulse control. The 3-factor model of PANSS and its subscales showed robust reliability and generalisability of their assessment scores across the UHR population and evaluation periods (G = 0.77–0.93), offering a suitable means to assess psychosis risk. Certain subscales within the 5-factor PANSS model showed comparatively lower reliability and generalisability (G = 0.33–0.66). The identified and investigated fluctuating symptoms in UHR individuals are more amendable by means of intervention, which could have significant implications for preventing and addressing psychosis. Prioritising the treatment of fluctuating symptoms could enhance intervention efficacy, offering a sharper focus in clinical trials. At the same time, using more reliable total scale and 3 subscales can contribute to more accurate assessment of enduring psychosis patterns in clinical and experimental settings.

Cross-Cultural Comparison of the Strengths and Difficulties Self-Report Questionnaire in 12 Asian and European Countries

The self-report Strengths and Difficulties Questionnaire (SDQ) is widely used globally; hence, the validity of the intergroup comparisons is essential. This study examined the structure of the self-report SDQ in a large multinational adolescent sample, tested its measurement invariance across genders and countries, and compared youth mental health in 12 European and Asian countries. This study is part of the Eurasian Child Mental Health Study (EACMHS), a cross-cultural research study of child and adolescent well-being and mental health in 12 Asian and European countries. The sample (N= 26,306) came from a cross-sectional school-based survey of adolescents. Confirmatory factor analysis was used to assess a common measurement model for the self-report SDQ and the measurement invariance of the model across gender and country. Fit indices in the total sample, in each gender, and in each of the 12 countries separately supported the use of the first-order 3-factor model (without the reverse-coded items) as a common measurement model for the self-report SDQ. Measurement invariance analyses provided good support for configural, metric, and scalar invariance across gender; however, metric invariance across countries was not supported. There were significant gender main effects for all SDQ subscales except for hyperactivity/inattention. Culture had significant main effects and moderated the magnitude of gender differences in all subscales. The present findings support the use of the correlated 3-factor model comprising the positive dimension of prosocial behavior and 2 broad groupings of internalizing and externalizing problems, without the reverse-coded problem items, as a common measurement model for the self-report SDQ internationally.

Psychometric properties of the multifactor leadership questionnaire when used in early-career pharmacists with provisional registration

BackgroundThe Multifactor Leadership Questionnaire (MLQ) is a validated instrument used to explore participants' perceptions of leadership and the Outcomes of leadership, participants' evaluation of and satisfaction with leadership and willingness to put in extra effort. The factor structure of MLQ varies across studies. The aim was to explore the psychometric properties of the MLQ for early-career pharmacists rating their preceptor's leadership. MethodsThe MLQ was administered to provisionally registered pharmacists during the final half of their 1 year of supervised practice. Confirmatory and Exploratory Factor Analysis (CFA & EFA) and Structural Equation Modeling (SEM) were used to analyse the data. ResultsResponses were obtained from 430 participants (25 % of all Australian pre-registration pharmacists at the time). CFA demonstrated that the original 9-factor model and a range of previously published models were poor fit for the data. EFA revealed that a good fit was a model with 4 factors named: Passive laissez-faire, Strategic visionary, Personalized, and Active management by exception. Passive laissez-faire and Active management by exception were consistent with previously published models. The Strategic visionary and Personalized factors were interpreted as 2 forms of transformational leadership that includes the provision of rewards depending on performance. A SEM of MLQ sub-scales predicting Outcomes of leadership explained 90.3 % of variance. Personalized leadership was highly predictive (β = 0.743, P < 0.001) while the three other factors had negligible effects. ConclusionThe psychometric analyses demonstrated overlap of the original 9-factors. A more parsimonious 4-factor model fit the data well.

Development and validation of the self-report symptom inventory of immune-related adverse events in patients with lung cancer

ObjectivesThis study aims to develop and validate the Self-Report Symptom Inventory of immune-related Adverse Events in Patients with Lung Cancer (SRSI-irAEs-LC) to allow for systematic assessment of symptomatic irAEs in lung cancer patients treated with programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs). MethodsA sequential two-phase mixed-methods study was conducted. In phase Ⅰ, a draft version of the SRSI-irAEs-LC was constructed through item generation and draft inventory construction. Delphi expert consultation, cognitive interviews and a pilot study were conducted to evaluate the content validity and refine the scale. In phase Ⅱ, psychometric testing was performed on 512 lung cancer patients treated with PD-1/PD-L1 ICIs using item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), criterion validity, discriminant validity, and reliability evaluations. ResultsThrough 5 sequential steps in phase Ⅰ, the preliminary version of the SRSI-irAEs-LC comprised 10 dimensions with 41 items. Through EFA, the final version of the SRSI-irAEs-LC included 8 dimensions and 26 items that explained 62.33% of the variance. The CFA model showed that the 8-factor model fitted the data well. Good criteria validity and known-groups discriminant validity were demonstrated. Cronbach's alpha, split-half reliability, and test-retest reliability of the scale were 0.824, 0.725, and 0.851, respectively. ConclusionsPreliminarily, the SRSI-irAEs-LC is a valid and reliable instrument for assessing symptomatic irAEs in lung cancer patients treated with PD-1/PD-L1 ICIs. Further research is needed to confirm its generalizability to a broader population as well as its validity and reliability.

Injury, substance abuse, verbal abuse, and emotional and behavioral issues among adolescents in Uttarakhand, India: A categorical principal component analysis of global school-based health survey

Background: Adolescents in low-middle-income countries face increasing physical and mental health challenges. The present study aimed to assess status of injury, verbal abuse, substance use, and emotional behavior of adolescents of Uttarakhand, India, and evaluate the importance of each component. Methods: A cross-sectional study was conducted among adolescents in 13 government schools in Uttarakhand using the Global School-based Health Survey (GSHS). Categorical principal component analysis (CATPCA) using Varimax rotation was performed to analyze principal components among two domains of GSHS (substance abuse domain and verbal abuse and emotional behavior domain). Factorability was assessed using Kaiser–Meyer–Olkin and Bartlett’s test. Variance Accounted For index was used to evaluate the importance of each component. Results: A total of 634 adolescents completed the questionnaire. 41.3% students suffered from serious injury with a significant difference (P &lt; 0.0001) between both genders. Girls were more likely to report having felt lonely most of the time or always in the past 12 months (11.0% vs 4.6%, P = 0.018). Boys were more likely to miss classes on 3 or more days (9.9% vs 4.9%, P = 0.043). Initiation of smoking cigarettes (9.6% vs 1.2%, P &lt;0.0001) and tobacco chewing (3.4% vs 0.3%, P = 0.001) was more likely in 12–15-year-old boys. One-third of the students reported male guardians to use either alcohol or some form of tobacco. CATPCA yielded an 11-factor model accounting for 58.26% of variances with the most important principal component named “Tobacco (Smoking and Chewing): Initiation, Frequency and Attempt to Stop” (eigenvalue: 4.109). Conclusion: Significant differences in various items of injury, verbal abuse, substance use, and emotional behavior were recorded between boys and girls. CATPCA revealed patterns among injury, verbal abuse, emotional behavior, and substance abuse domains of GSHS by categorizing them into 11 components. On the basis of these patterns, prioritizing and development of appropriate school-based interventions may be implemented by various stakeholders of Uttarakhand.