Acceptable Fit Indices Research Articles

Sisvan food intake markers: structure and measurement invariance in Brazil.

To characterize the internal structure of the Food and Nutrition Surveillance System (Sisvan) form of food intake markers for individuals over 2 years of age and to investigate measurement invariance between Brazilian macro-regions, life stages and over the years. A parallel analysis with factor estimation was carried out, complemented with exploratory factor analysis using all Sisvan records with valid responses in the country in 2015 (n = 298,253). Only the first record per individual was considered. Next, multigroup confirmatory factor analysis was used to investigate configural, metric and scalar invariance between the five macro-regions (Midwest, Northeast, North, Southeast, South) and life stages (children, adolescents, adults, elderly) in the same reference year. Invariance was evaluated longitudinally using valid individual records from 2015 to 2019 (n = 4,578,960). The adequacy of fit indices was observed at each step. Acceptable fit indices and adequate factor loadings were found for a two-dimensional model, which grouped ultra-processed foods (factor 1) and unprocessed or minimally processed foods (factor 2). The two-dimensional structure, with the respective items in each factor underlying the set of markers, was equivalent across macro-regions, life stages and longitudinally, confirming the configural invariance. The weights of each item and its scale were homogeneous for all groups of interest, confirming metric and scalar invariances. The internal structure of the Sisvan form of food intake markers adequately reflected its conceptual foundation, with stability of factors related to healthy and unhealthy eating in configuration, weights and scale in the investigated categories. These findings qualify food and nutritional surveillance actions, enhancing the use of Sisvan food intake markers in research, monitoring, individual guidance, and care production in the Brazilian Unified Health System.

Spanish validation of short-form version of Literacy of Suicide Scale (LOSS) and Stigma of Suicide Scale (SOSS).

The evidence shows that a greater understanding of mental health and the myths about suicide is related to a reduction in these types of problems. Validate the Literacy of Suicide Scale-Short Form (LOSS-SF) and the Stigma of Suicide Scale-Short Form (SOSS-SF) for Spain. Both scales were translated to Spanish via backward translation. The sample was comprised of a total of 466 participants, of which 169 (36.2%) were men and 297 (63.6%) were women through nonrandom circumstantial sampling. The questionnaires were administered online. To test the factorial structure and evaluate reliability, both an EFA and an AFC were conducted. In addition, the reliability of the questionnaires was analyzed using the Omega coefficient and Cronbach's alpha. Finally, a linear regression analysis was carried out with the aim of testing the predictability of the scales. The results obtained reveal acceptable fit indices and a factorial structure similar to that of the validation conducted for both instruments in other countries. The validity of these instruments for use in Spain is discussed.

Cultural adaptation of the revised Basel Instrument for Rationing of Care to the Turkish context: a study of validity and reliability.

Studies have shown that nurses do not complete one or more necessary nursing care elements in their last shift due to lack of time. The Basel Extent of Rationing Nursing Care (BERNCA) instrument is one of the most used scales to measure the rationing of nursing care. This study is aimed to culturally adapt the revised BERNCA (BERNCA-R) instrument to the Turkish language and to test its validity and reliability. A cross-sectional and methodological study was used. The instrument was adapted in three stages: translation and adaptation, content validity testing and validity and reliability. Data were obtained from 350 nurses working in two public acute care hospitals in Turkey, between September 2019 and January 2020. The descriptive statistics, content validity index, exploratory and confirmatory factor analyses, Cronbach's α, Guttman split-half and inter-item reliability analyses were performed for the analysis of the data. The Turkish version of the BERNCA-R instrument with a 27-item and three-subscales (monitoring, daily care and needs and psychosocial care) structure was found to have acceptable and good fit indices. The Turkish version of the BERNCA-R instrument is valid and reliable tool to measure rationing of nursing care.

Psychometric properties and general population reference values for PROMIS Global Health in Hungary

ObjectivesPatient-Reported Outcomes Measurement Information System–Global Health (PROMIS-GH) is a widely used generic measure of health status. This study aimed to (1) assess the psychometric properties of the Hungarian PROMIS-GH and to (2) develop general population reference values in Hungary.MethodsAn online cross-sectional survey was conducted among the Hungarian adult general population (n = 1700). Respondents completed the PROMIS-GH v1.2. Unidimensionality (confirmatory factor analysis and bifactor model), local independence, monotonicity (Mokken scaling), graded response model fit, item characteristic curves and measurement invariance were examined. Spearman’s correlations were used to analyse convergent validity of PROMIS-GH subscales with SF-36v1 composites and subscales. Age- and gender-weighted T-scores were computed for the Global Physical Health (GPH) and Global Mental Health (GMH) subscales using the US item calibrations.ResultsThe item response theory assumptions of unidimensionality, local independence and monotonicity were met for both subscales. The graded response model showed acceptable fit indices for both subscales. No differential item functioning was detected for any sociodemographic characteristics. GMH T-scores showed a strong correlation with SF-36 mental health composite score (rs = 0.71) and GPH T-scores with SF-36 physical health composite score (rs = 0.83). Mean GPH and GMH T-scores of females were lower (47.8 and 46.4) compared to males (50.5 and 49.3) (p < 0.001), and both mean GPH and GMH T-scores decreased with age, suggesting worse health status (p < 0.05).ConclusionThis study established the validity and developed general population reference values for the PROMIS-GH in Hungary. Population reference values facilitate the interpretation of patients’ scores and allow inter-country comparisons.

Translation, cultural adaptation and validity assessment of the Dutch version of the eHealth Literacy Questionnaire: a mixed-method approach

BackgroundThe digitalization of healthcare requires users to have sufficient competence in using digital health technologies. In the Netherlands, as well as in other countries, there is a need for a comprehensive, person-centered assessment of eHealth literacy to understand and address eHealth literacy related needs, to improve equitable uptake and use of digital health technologies.ObjectiveWe aimed to translate and culturally adapt the original eHealth Literacy Questionnaire (eHLQ) to Dutch and to collect initial validity evidence.MethodsThe eHLQ was translated using a systematic approach with forward translation, an item intent matrix, back translation, and consensus meetings with the developer. A validity-driven and multi-study approach was used to collect validity evidence on 1) test content, 2) response processes and 3) internal structure. Cognitive interviews (n = 14) were held to assess test content and response processes (Study 1). A pre-final eHLQ version was completed by 1650 people participating in an eHealth study (Study 2). A seven-factor Confirmatory Factor Analysis (CFA) model was fitted to the data to assess the internal structure of the eHLQ. Invariance testing was performed across gender, age, education and current diagnosis.ResultsCognitive interviews showed some problems in wording, phrasing and resonance with individual’s world views. CFA demonstrated an equivalent internal structure to the hypothesized (original) eHLQ with acceptable fit indices. All items loaded substantially on their corresponding latent factors (range 0.51–0.81). The model was partially metric invariant across all subgroups. Comparison of scores between groups showed that people who were younger, higher educated and who had a current diagnosis generally scored higher across domains, however effect sizes were small. Data from both studies were triangulated, resulting in minor refinements to eight items and recommendations on use, score interpretation and reporting.ConclusionThe Dutch version of the eHLQ showed strong properties for assessing eHealth literacy in the Dutch context. While ongoing collection of validity evidence is recommended, the evidence presented indicate that the eHLQ can be used by researchers, eHealth developers and policy makers to identify eHealth literacy needs and inform the development of eHealth interventions to ensure that people with limited digital access and skills are not left behind.

Adaptation and psychometric testing of the end-of-life professional caregiver survey in Jamaica

BackgroundUsing a validated instrument to measure palliative care (PC) educational needs of health professionals is an important step in understanding how best to educate a well-versed PC workforce within a national health system. The End-of-life Professional Caregiver Survey (EPCS) was developed to measure U.S. interprofessional PC educational needs and has been validated for use in Brazil and China. As part of a larger research project, this study aimed to culturally adapt and psychometrically test the EPCS among physicians, nurses, and social workers practicing in Jamaica.MethodsFace validation involved expert review of the EPCS with recommendations for linguistic item modifications. Content validation was carried out by six Jamaica-based experts who completed a formal content validity index (CVI) for each EPCS item to ascertain relevancy. Health professionals practicing in Jamaica (n = 180) were recruited using convenience and snowball sampling to complete the updated 25-item EPCS (EPCS-J). Internal consistency reliability was assessed using Cronbach’s alpha coefficient and McDonald’s phi. Construct validity was examined through confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).ResultsContent validation led to elimination of three EPCS items based on a CVI < 0.78. Cronbach’s alpha ranged from 0.83 to 0.91 and McDonald’s phi ranged from 0.73 to 0.85 across EPCS-J subscales indicating good internal consistency reliability. The corrected item-total correlation for each EPCS-J item was > 0.30 suggesting good reliability. The CFA demonstrated a three-factor model with acceptable fit indices (RMSEA = 0.08, CFI = 0.88, SRMR = 0.06). The EFA determined a three-factor model had the best model fit, with four items moved into the effective patient care subscale from the other two EPCS-J subscales based on factor loading.ConclusionsThe psychometric properties of the EPCS-J resulted in acceptable levels of reliability and validity indicating that this instrument is suitable for use in measuring interprofessional PC educational needs in Jamaica.

Does the Coronavirus Anxiety Scale Measure Coronaphobia the Same Way for Mourners With and Without Dysfunctional Grief?

Deaths from COVID-19 have exceeded 6.5 million people globally. Although many people are mourning the loss of loved ones to this deadly disease, little is known about the validity of measuring coronavirus-related anxiety with this particular group of people. Therefore, the objective of this study is to determine if the coronavirus anxiety scale (CAS) measures the coronaphobia construct the same way for mourners with and without dysfunctional levels of grief. The results indicated that the four-item version of the CAS has acceptable fit indices and is partially invariant between people with dysfunctional and non-dysfunctional grief. Moreover, the CAS demonstrated adequate criterion validity and reliability with this group of bereaved adults. In conclusion, the CAS can be used to measure anxiety due to COVID-19 in people who are going through dysfunctional and non-dysfunctional grieving processes.

Predicting perceived exclusive breastfeeding behavior among higher education female students in Saudi Arabia: Application of the theory of planned behavior using structural equation modeling.

The decision for infant feeding behaviors is often made early in life, based on the socio-cultural context. Thus, exploring this issue and its influencing factors can create Exclusive Breastfeeding (EBF) culture among future mothers. This study aimed to predict EBF behavior among female higher education students in Saudi Arabia through the application of the Theory of Planned Behavior (TPB) using Structural Equation Modeling (SEM). This descriptive exploratory research was conducted on three university campuses in three cities (Dammam, Jeddah, and Abha). A multistage cluster random sampling was employed to select 600 female students using a digital survey containing three sections: Personal Data and Previous BF Exposure, EBF Knowledge Scale, and The TPB constructs for the EBF scale (attitude, Subjective Norms/SN, Perceived Behavioral Control/PBC, intention, and Perceived Behavior). The results showed that the highest percent of the participants had moderate BF exposure (63.8%) and knowledge (65.7%), positive attitude (85.8%), high SN (66.2%), moderate PBC (75.8%), high intention (55.2%), and positive perceived behavior (55.2%). The SEM had acceptable fit indices were χ2/df ratio=3.817, GFI=0.935, RMSEA=0.044, NFI=0.942, CFI=0.951, PCFI =0. 924. It showed that the EBF attitude (β=0.607), SN (β=0.123), and PBC (β=0.158) were significant positive and direct predictors of the EBF intention (P <0.001). Both intention (β=0.213) and PBC (β=0.226) were significant positive and direct predictors of the perceived behavior (P <0.001). It accounted for 49.5% of the variance in EBF intention and 70.0% for the behavior. The BF exposure and knowledge were significant positive predictors of EBF intention (β=0.158, β= 0.237) and behavior (β=0.140, β= 0.207) (P=0.000). Thus, the TPB has a good predictive ability for EBF intention and behavior among the studied Saudi female university students. Thus, it can be employed for efficient health promotion and the development of EBF-friendly policies.

Nursing students’ nomophobia, social media use, attention, motivation, and academic performance: A structural equation modeling approach

AimTo investigate the interrelationships of nomophobia, social media use, attention, motivation, and academic performance among nursing students. BackgroundThere is a preponderance of studies about nursing students’ nomophobia, social media use, and academic performance. However, the mediating role of motivation and attention between nomophobia and academic performance remains a blind spot in nursing literature. DesignCross-sectional design and structural equation modeling (SEM) approach. MethodStudents from five nursing institutions in the Philippines were recruited via convenience sampling (n = 835). We used STROBE guidelines in reporting this study. Three self-report instruments (Motivational Strategies for Learning Questionnaire [MSLQ], Media and Technology Usage and Attitude Scale [MTUAS], and Nomophobia Questionnaire [NMP-Q]) were used to collect data. SEM, mediation analyses, and path analyses were used for data analysis. ResultsThe emerging model afforded acceptable model fit indices. Nursing students’ nomophobia positively influenced social media use whereas negatively impacting motivation and attention. Social media use, motivation, and attention directly affect academic performance. Path analyses depicted that motivation and attention mediated the indirect effect of nomophobia on academic performance. Motivation mediated the indirect impact of nomophobia on attention. Finally, attention mediated the indirect effect of motivation on academic performance. ConclusionNursing institutions and educators can use the proposed model in developing guidelines for evaluating nomophobia and regulating social media use in the academic and clinical context. These initiatives could support nursing students’ transition from school to practice while assisting them in maintaining their academic performance.

Family Quality of Life and Family Satisfaction Measures for Use in Slovakia: Confirmatory Factor Analyses

The aim of this study is to provide evidence to support the measurement of psychological concepts of family functioning in Slovakia. The first objective was to verify the psychometric properties of two scales assessing family quality of life and family satisfaction: the Beach Center Family Quality of Life Scale (BFQOLS) and the Family APGAR in people from a standard population (without disabilities). The second objective was to determine the relationship between family quality of life and family satisfaction with life satisfaction, self-esteem, income, and socio-economic status. The sample of participants comprised 499 adult respondents from Slovakia, 250 men and 249 women aged 18–60 years. In addition to the BFQOLS and the Family APGAR, scales were used to measure socioeconomic status, self-esteem, and satisfaction with life. As the results indicate, the factor structure of scales with acceptable fit indices was confirmed using confirmatory factor analysis. The scales showed good reliability and further analyses appear to support convergent and discriminatory validity of the scales. Based on the results obtained, the Slovak translation of the scales can be recommended for further verification and use in the standard population (without disabilities).

Translation and Validation of the Malay Perceived Stress Scale Modified for COVID-19.

Stress amidst the COVID-19 pandemic is becoming more prevalent. This paper aimed to describe the validation process of the Malay Perceived Stress Scale modified for COVID-19 (PSS-10-C) amongst Malaysian youths. The cross-sectional validation study design was employed in this study. In Phase I, the scale was translated into Malay by using the forward-backward method. In Phase 2, principal axis factoring and confirmatory factor analysis were conducted in Study 1 (n = 267) and Study 2 (n = 324), respectively. A two-factor solution, comprising 'distress' and 'coping' domains was derived (cumulative variance = 65.2%) in Phase 2. Concurrent validity evaluated via the Beck Hopelessness Scale revealed a moderate positive correlation (0.528). In Study 2 (n = 324), the confirmatory factor analysis showed that the two-factor model achieved acceptable model fit indices, including χ2/df ratio = 2.57; root mean square error of approximation (RMSEA) = 0.07; 95% CI = 0.05, 0.09; Tucker-Lewis Index (TLI) = 0.95 and Normed Fit Index (NFI) = 0.94. The Cronbach's alpha scale score was 0.855 for the study samples. The Malay PSS-10-C is a valid and reliable scale to be used amongst Malaysian youths.

Victim blaming, prior history to sexual victimization, support for sexually assaulted friends, and rape myths acceptance as predictors of attitudes towards rape victims in the general population of Pakistan

BackgroundIndividuals who have been sexually assaulted often turn to their friends for comfort and support. Responses to such disclosures vary greatly and may be influenced by prior victimization, the relationship of the disclosure recipient to the accused, and the recipient’s acceptance of rape myths. Moreover, currently there are no studies to date that have validated the Illinois Rape Myths Acceptance Model in Pakistan.MethodTo gain a better understanding of this phenomenon, the online survey was administered to the general population. Of this sample, 512 (consisting of 312 females and 200 males) reported having received a rape disclosure from a friend.ResultsThe results showed that having lower scores on rape myths acceptance (being less likely to endorse rape myths) was significantly associated with positive attitudes towards rape victims. Similarly, being female, having graduate or above level education, not blaming the victim, having prior history of sexual victimization, offering support for friends experiencing sexual assault, and being liberal were significantly associated with positive attitudes towards rape victims. Additionally, confirmatory factor analysis of the Illinois Rape Myths Acceptance Scale showed acceptable model fit indices and relevance to the Pakistani context.ConclusionIn conclusion, it has been assessed through the results that showed that having lower scores on rape myths acceptance (being less likely to endorse rape myths) was significantly associated with positive attitudes towards rape victims. Similarly, being female, having graduate or above level education, not blaming the victim, having prior history of sexual victimization, offering support for friends experiencing sexual assault, and being liberal were significantly associated with positive attitudes towards rape victims. It is further concluded that having experienced sexual victimization leads individuals towards showing empathy to rape victims and thus may influence them to provide support for such victims. The findings further show that Illinois Rape Myths Acceptance is a valid measure for measurement of rape myths in Pakistan as established through the acceptable model fit indices. With the use of validated scales, we could gain a better understanding of rape and the factors related to it, which could be used to inform practices and policy decisions.

Psychometric properties and invariance of the scale to measure attitude of researchers for university-industry collaboration

The psychometric properties of the Scale to measure the attitude of researchers for scientific-technological collaboration between universities and industry (EA-COOPTEC, for its acronym in Spanish) were analyzed, specifically evidence of construct validity of the internal structure and invariance for gender and age was obtained. The EA-COOPTEC was administered to 179 academic Teachers–Researchers (T-Rs) involved in Universities-Industry Collaboration (UIC) activities: 50 women and 129 men. Participants had a median age of 36–40 years. A descriptive analysis was implemented, as well as an Exploratory and Confirmatory Factor Analysis (EFA and CFA), and a method of succession of nested models for invariance testing. A four-factor model explaining the perception of UIC activities was generated and evidence of invariance for gender and partial invariance for age was obtained. Acceptable fit indices were obtained for the configurational, weak, strong and strict. Given the results, we recommend the use of the EA-COOPTEC v0.1 for the analysis of the mean differences between genders and age in T-Rs.

한국판 시뮬레이션 디브리핑 평가 도구(K-DASH) 신뢰도와 타당도 검증

Objectives Debriefing is the core of simulation education that helps learners to meaningfully structure their experience. A valid and reliable scale capable of evaluating debriefing in Korean culture is required. This study translated the Debriefing Assessment for Simulation in Healthcare (DASH), into Korean, and analyzed its validity and reliability. Methods A total of 66 participants from nursing colleges in 3 different regions evaluated the tools and 4 participated via in-depth interviews. Results A one-factor model showed acceptable fit indices (χ2=20.21, χ2/df=2.25, comparative fit index=.95, standardized root mean square residual=.05, normed fit index=.91, tucker-lewis index=.92, root mean square error of approximation=.15). Via in-depth interviews, using K-DASH was identified to helped in successful debriefing. Cronbach’s α was .94. Conclusions This study demonstrated acceptable validity and reliability of K-DASH and its introduction into the Korean simulation curriculum can improve the efficacy of simulation education.

Translation and validation of Greek version of the Pandemic Grief Scale

IntroductionThose who have lost loved ones to COVID-19 may be considered at risk of complicated grief. A 5-item mental health screening tool called the Pandemic Grief Scale (PGS) was developed to find likely instances of dysfunctional grief during the pandemic.ObjectivesTo develop a Greek version of PGS and to explore the validity and reliability among the general population in Greece in order to further use it as clinical mental health screener.MethodsWe conducted a cross-sectional study between January and April 2022, and 342 persons were recruited. The questionnaire included socio-demographic parameters, the PGS, the Brief Resilience Coping Scale to capture tendencies to cope with stress and the Athens Insomnia Scale to assess the insomnia symptoms. Based on experiences over the previous two weeks, each PGS item is scored on a 4-point scale, from 0 (not at all) to 3 (almost every day), with higher rating and a cut-off of 7 indicating dysfunctional grief. Prior to the psychometric validation a linguistic validation and adaptation in Greek was performed.ResultsA total of 342 patients participated in the study, 67.8 % were females and 27.8% were 18-30 years old. Coefficient Validity Ratio (CVR) results showed that 100% (n = 5) of items were acceptable. Value of Cronbach’s alpha was found 0.848. A one-factor model was conducted by Confirmatory Factor Analysis (CFA), giving acceptable global fit indices. The resulting global fit indices [Standardized Root Mean Square Residual (SRMR) = 0.037, Comparative Fit Index (CFI) = 0.952, Tucker–Lewis Index (TLI)= 0.903] showed that the 5 items in one-factor solution proposed by the primary researchers shouldn’t be rejected for the Greek version. The Bartlett Test of Sphericity was 758.08 (p &lt;0.001). The Kaiser-Meyer-Olkin Measure of Sampling Adequacy was 0.826, showing that the data is suitable for factor analysis. The one-factor solution derived in our study consisted of 5 items. The total explained variance was 64.3 %.ConclusionsThe findings of this research support the PGS psychometric validity and reliability. PGS is suitable to be used in healthcare to identify and assist individuals, who are experiencing this type of pandemic-related dysfunctional grief as it is a screening tool that it’s simple to use, access, and understand.Disclosure of InterestNone Declared

Validation of the inventory of Callous-Unemotional Traits among school-going adolescents in Malaysia.

A key component in the study of antisocial behaviour among adolescents is the presence of callous-unemotional (CU) traits. Among the established tools available to measure CU traits is the Inventory of Callous-Unemotional traits (ICU). To date, there is no validated questionnaire to assess CU traits for the local population. Therefore, there is a need to validate the Malay version of the ICU (M-ICU) so that research can be conducted to explore CU traits among adolescents in Malaysia. The aim of the study is to validate the M-ICU. Two phases of cross-sectional study involving 409 (phase 1 -exploratory factor analysis (EFA), n = 180; phase 2-confirmatory factor analysis (CFA), n = 229) adolescents aged between 13 to 18 years old were conducted from July until October 2020 at six secondary schools in Kuantan district. Participants were selected via multistage random sampling. The ICU was initially translated into Malay language using forward-backward translation procedure by a group of bilingual researchers. Study participants completed the final version of the M-ICU questionnaire and socio-demographic questionnaire. Data was analysed using SPSS version 26 and MPlus software for factor structure validity by performing EFA and CFA. Initial EFA revealed three factors with two items deleted. A further EFA with two factors resulted in the deletion of unemotional factor items. Cronbach's alpha for overall scale improved from 0.70 to 0.74. CFA supported a two-factor solution with 17 items compared to the original English version that has three factors with 24 items. The findings revealed acceptable fit indices (RMSEA = 0.057, CFI = 0.941, TLI = 0.932, WRMR = 0.968). The study revealed that a two-factor model with 17 items of the M-ICU has good psychometric properties. The scale is valid and reliable to measure CU traits among adolescents in Malaysia.

Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers.

This study aimed to examine the internal structure and assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) in a Puerto Rican sample of workers. This instrument is a nine-item questionnaire, which was conceptualized as a unidimensional structure; however, there are mixed results regarding this internal structure. This measure is used in the occupational health psychology context in organizations in Puerto Rico; nevertheless, there is little evidence of its psychometric properties with samples of workers. A total of 955 samples from two different study samples were used in this cross-sectional study design in which the PHQ-9 was used. We conducted confirmatory factor analysis, bifactor analysis, and random intercept item factor analysis to examine the internal structure of the PHQ-9. Moreover, a two-factor model was examined by randomly assigning items to the two factors. Measurement invariance across sex and the relationship with other constructs were examined. The best-fitted model was the bifactor model followed by the random intercept item factor. The five sets of two-factor models with items randomly assigned obtained acceptable and similar fit indices regardless of the items. The results suggest that the PHQ-9 appears to be a reliable and valid instrument to measure depression. The more parsimonious interpretation of its scores, for now, is a unidimensional structure. Comparison across sex appears to be useful in occupational health psychology research settings since the results suggest that the PHQ-9 is invariant regarding this variable.

Development and validation of the novel nursing activities in the care of extracorporeal membrane oxygenation-supported patients scale.

Nurses are members of multidisciplinary teams providing care to extracorporeal membrane oxygenation-supported patients (ECMO-SP). There are no valid and reliable measurements available to assess nursing activities in the care of ECMO-SP. To develop and evaluate psychometric properties of a new 27-item nursing activities in the care of ECMO-SP scale. A convenience sample was recruited of 76 registered nurses (mean age 41.3 ± 8.7; 71% female) in Israel. The nurses participated in an online survey with software Qualtrics, between March and June 2022. Content and construct validity, as well as internal consistency of the scale were evaluated. The participants also completed the perceived knowledge and skills in the treatment of ECMO-SP scale. The correlations between nursing activities in the care of ECMO-SP and ECMO knowledge were examined using Pearson's correlation. Exploratory factor analysis extracted four factors, and seven items were excluded from the 27-item scale making it a 20-item scale in its final form. Internal consistency was acceptable for the total scale (α=0.84) and the four subscales: Factor 1: Nursing care of ECMO-SP not related to the ECMO device (α=0.90), Factor 2: Activities on ECMO device in emergency (α=0.82), Factor 3: ECMO device calibrating and monitoring (α=0.72), and Factor 4: Medication and blood administration through ECMO device (α=0.73). When examined in confirmatory factor analysis, the 20-item scale yielded acceptable fit indices. A positive correlation was found between perceived ECMO knowledge and all four factors of the nursing activities in the Care of ECMO-SP scale. The 20-item scale examining nursing activities in the care of ECMO-SP is ready for use for clinical, educational, and research purposes. Because there are still no standards for nursing care of ECMO-SP and no agreed quality indicators, this novel scale may help in building such standards and quality indicators.

Bifactor SEM and MIRT Structure of a 12-Item Human Immunodeficiency Virus Stigma Scale in Peruvian Adults.

The stigma associated with human immunodeficiency virus (HIV) can lead to prejudice and discrimination against people who have been infected by this virus, consequently, it is important to have a validated tool to measure this phenomenon. However, there is only 1 national precedent that has validated the scores of this instrument in its 21-item version. Therefore, this study examined the bifactor structural equation method (SEM) and multidimensional item response theory (MIRT) structure of a 12-item human immunodeficiency virus stigma scale in Peruvian adults. We evaluated 342 patients (57.6% female and 42.45% male) diagnosed with HIV receiving highly active antiretroviral therapy (HAART) from a hospital located in East Lima, aged 18 to 45 years (M = 31.4, SD = 9.79). A SEM was used to test 2 measurement models, a 4-factor correlated oblique model and a bifactor model due to high interfactor relationships. Acceptable fit indices were identified for the oblique model (χ2/df = 1.26, SRMR = 0.044, RMSEA [90% CI] = 0.028 [0.000-0.047], CFI = 0.996, TLI = 0.994). In the same way, similar results were evident for the bifactor model (χ2/df = 1.14, SRMR = 0.039, RMSEA [90% CI] = 0.020 [0.000-0.044], CFI = 0.998, TLI = 0.997), however, in the latter it showed a greater explanation for the unidimensional model (H = 0.87, PUC = 0.82, LCA = 0.70), which was also evidenced by the bifactor MIRT analysis. It is concluded that the 12-item HIV Stigma Scale meets the psychometric properties of internal structure and unifactorial reliability.

The best of two worlds: Combining the DSM-5 and ICD-11 clusters of symptoms for posttraumatic stress disorder in a single screening scale.

The most recent DSM-5 (2013) and ICD-11 (2018) diagnostic criteria for posttraumatic stress disorder (PTSD) encompass 20 and six symptoms, respectively, organized in different structures. This study aimed to investigate the dimensions of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) according to the DSM-5's broader definition of PTSD and the ICD-11's narrower approach, as well as to explore an alternative restricted model that retains the core symptoms explicitly related to traumatic experiences. Data were gathered from Brazilian employees (n=1,101) who had directly experienced traumatic life events or had been exposed to them because of their work activities. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to evaluate the configural and metric structures of the models. We estimated seven models of the latent structure of PTSD including the four-factor DSM-5 and three-factor ICD-11 PTSD models. Given the lack of evidence of their validity, an alternative 10-symptom model was tested. The final seven-item PTSD model considerably improved estimation of the PTSD construct. This solution showed reliable items with non-redundant content, acceptable fit indices, and satisfactory configural and metric properties. The more parsimonious one-dimensional model comprising the core PTSD symptoms has the potential to improve assessment of PTSD.