Acceptable Indices Research Articles

Milk Proteins as Alternative Ingredients Replacing Sugar and Their Effects on Chemical, Technological and Sensory Quality of Cookies

ABSTRACT This paper aims to evaluate nutritional, technological and sensory characteristics of cookies with reduced sugar content and added milk proteins. Five formulations of cookies had their weight, height, weight loss, yield, apparent volume, specific volume, spread ratio, color, pH, texture, proximate composition, acceptability, purchase intention and acceptability index were evaluated. Cookies made with low sugar presented promising quality for apparent volume, specific volume, spread ratio and yield. High protein and ashes content, lower moisture and low sugar concentration were also observed. Treatments added with whey protein highlighted in the sensory analysis and reached a satisfactory acceptability index. Cocoa powder can covered up the sugar reduction and can be used in cookies formulation to diminish sugar. Casein did not show potential as an alternative for cookies. Cookies produced with low sugar and added with whey protein had appropriate chemical, technological and sensory characteristics.

The Farsi version of Caregiver Preparedness Scale in Iranian family caregivers of the older adults undergoing hemodialysis: a psychometric study

BackgroundEnhancing preparedness of family caregivers and support for caregiving is essential for the mutual benefit of both caregivers and the well-being of those under their care. This study aimed to translate and evaluate psychometric properties of the Caregiver Preparedness Scale among family caregivers of older adults undergoing hemodialysis.MethodsIn this methodological study, 400 family caregivers of older adult patients undergoing hemodialysis enrolled to the study via convenience sampling method. The study was conducted in two stages: translation and psychometric evaluation. At first, the translation of the scale was done using Beaton et al. method. In the psychometric evaluation stage, quantitative face validity, content validity, item analysis and construct validity of the scale were evaluated. The internal consistency of the scale was assessed through the calculation of Cronbach’s alpha, McDonald’s omega, and average inter-item correlation coefficients.ResultsAll items had an impact score greater than 1.5. The content validity ratio and the kappa coefficient for all items were above 0.75. In the item analysis, item 2, which had a correlation with the total score of less than 0.3, was removed. Following exploratory factor analysis, only one factor composed of all items (7 items) was extracted, explaining 75.7% of the total variance. This model had acceptable fit indices in confirmatory factor analysis. Cronbach’s alpha and omega of 0.95 and an average inter-item correlation of 0.75 were obtained.ConclusionsThe study results demonstrated that the Caregiver Preparedness Scale exhibits appropriate psychometric properties. Geriatric nurses can utilize this Scale for assessment of caregivers. This assessment can aid in decision-making regarding educational programs aimed at enhancing family caregiver preparedness.

Does Menstrual Health and Endometriosis Education Affect Knowledge Among Middle and Secondary School Students? A Cluster-Randomised Controlled Trial

ObjectivesTo evaluate whether endometriosis and menstrual health education improves knowledge and attitudes among adolescents and is acceptable. MethodsWe conducted a cluster-randomised controlled trial in a Canadian school district. Eligible classes were grades 8–12, co-educational, and English. Classes were randomly assigned either to a 60-minute virtual menstrual health and endometriosis education program before (intervention) or after (waitlist control) primary data collection. The primary outcome was change in endometriosis knowledge from baseline to follow-up (∼4 weeks later, 6-item questionnaire). Secondary outcomes were changes in confidence in endometriosis knowledge, prioritisation of menstrual health knowledge, and comfort in discussing menstrual health, as well as intervention acceptability. The sexual health educator and statistician were masked. ResultsIn April and May 2021, 2 intervention classes and 2 control classes completed the study. In total, 71 students enrolled, and 48 were present on both baseline and follow-up days. Mean age was 15.7 ± 1.6 years, 55% identified as non-White ethnicities, and 53% were female. The knowledge score increased by 1.86 points in the intervention classes compared with 0.30 points in the control classes, with an estimated mean difference of 1.56 (95% CI 1.12–2.00). The intervention classes showed increased confidence in endometriosis knowledge, prioritisation of menstrual health knowledge, and comfort in discussing menstrual health, compared to the control classes. The mean acceptability index was 80 (SD = 10) in the intervention classes and 70 (SD = 20) in the control classes. ConclusionsA brief menstrual health and endometriosis education program improved knowledge and attitudes among adolescents, who considered the program acceptable.

Determinants of sedentary behavior in community-dwelling older adults with type 2 diabetes based on the behavioral change wheel: a path analysis

BackgroundSedentary behavior (SB) is deeply ingrained in the daily lives of community-dwelling older adults with type 2 diabetes mellitus (T2DM). However, the specific underlying mechanisms of the determinants associated with SB remain elusive. We aimed to explore the determinants of SB based on the behavior change wheel framework as well as a literature review.MethodsThis cross-sectional study recruited 489 community-dwelling older adults with T2DM in Jinan City, Shandong Province, China. Convenience sampling was used to select participants from relevant communities. This study used the Measure of Older Adults’ Sedentary Time-T2DM, the Abbreviated-Neighborhood Environment Walkability Scale, the Social Support Rating Scale, the Lubben Social Network Scale 6, the Subjective Social Norms Questionnaire for Sedentary Behavior, the Functional Activities Questionnaire, the Numerical Rating Scale, the Short Physical Performance Battery, and the Montreal Cognitive Assessment Text to assess the levels of and the determinants of SB. Descriptive statistical analysis and path analysis were conducted to analyze and interpret the data.ResultsPain, cognitive function, social isolation, and social support had direct and indirect effects on SB in community-dwelling older adults with T2DM (total effects: β = 0.426, β = -0.171, β = -0.209, and β = -0.128, respectively), and physical function, walking environment, and social function had direct effects on patients’ SB (total effects: β = -0.180, β = -0.163, and β = 0.127, respectively). All the above pathways were statistically significant (P < 0.05). The path analysis showed that the model had acceptable fit indices: RMSEA = 0.014, χ 2/df = 1.100, GFI = 0.999, AGFI = 0.980, NFI = 0.997, RFI = 0.954, IFI = 1.000, TLI = 0.996, CFI = 1.000.ConclusionCapability (physical function, pain, and cognitive function), opportunity (social isolation, walking environment, and social support), and motivation (social function) were effective predictors of SB in community-dwelling older adults with T2DM. Deeper knowledge regarding these associations may help healthcare providers design targeted intervention strategies to decrease levels of SB in this specific population.

Development of a scale examining post-disaster coping motivations in Turkey after the 6 February earthquake.

The aim of this study was to develop the Motivations for Coping After Disaster Scale. To test the construct validity of the scale, a total of 676 data were collected from three different sampling groups (N1: 388; N2: 194; N3: 94). Exploratory Factor Analysis, Confirmatory Factor Analysis (CFA) and Criterion validity analysis were conducted to test the construct validity of the scale. As a result of CFA, it was seen that the post-disaster scale had a five-dimensional structure (spiritual values, hope, friend support, solidarity, family support). The loadings of the items of the scale are at a good level. As a result of CFA, the scale was found to have acceptable and good fit indices (χ2/sd=2.690; RMSEA (Root Mean Square Error of Approximation)=0.066; SRMR (Standardized Root Mean Square Residual)=0.047; CFI (Comparative Fit Index)=0.948; GFI (Goodness of Fit Index)=0.917). The results of the criterion validity analysis show that the scale has criterion validity. Cronbach Alpha internal consistency coefficient shows that the scale is highly reliable (Total=0.923). The results of this study show that the Post-Disaster Coping Motivations Scale is a valid and reliable instrument. It is thought that the scale can make an important contribution to understanding psychological recovery processes after disaster and providing appropriate support to individuals.

A two-stage stochastic preference analysis on group decision making with interval additive preference relations

Interval additive preference relation (IAPR) is an efficient tool for describing the uncertain pairwise comparisons between alternatives in group decision-making (GDM). Existing GDM methods with IAPRs view the preference value as a whole and establish concrete conflict/consensus mechanisms for fusing individual opinions while neglecting the stochastic preference and aggregation modes to meet the different demands of decision. Thus, to reflect the stochastic characteristic in both preference representation and group preference aggregation, this paper presents a novel two-stage stochastic preference analysis on GDM with IAPRs. In first stage, the method involves extracting stochastic additive preference relations (SAPRs) from the IAPRs. A preference relations matrix is then established using a logarithmic least squares model applied to the SAPRs. In second stage, the weighted preference matrix is synthesized by combining the preference relations matrix with the decision makers’ weight space. This leads to the computation of positive and negative ideal preference solutions, as well as positive and negative preference distances. Subsequently, the relative preference closeness is calculated based on these distances. Relative ranking results are determined by an algorithm evaluating pairwise comparisons among alternatives, resulting in transitional preference rankings. The second stage involve deriving ranking acceptance indices and ranking confidence degrees through a continuous extraction process, facilitating the establishment of the ultimate best preference rankings. The proposed method’s effectiveness and validity are demonstrated by numerical examples and Monte Carlo simulations.

Validity and Reliability of the Sri Lankan Version of the Patient-Centered Questionnaire-Infertility (PCQ-Infertility)

Background: Reproductive healthcare of the highest calibre should encompass not only safety and effectiveness but also a patient-centered approach. Patients demand patient-centered subfertility treatment in addition to efficient medical management. Offering patient-centered care is crucial for both patients and healthcare professionals. The absence of a suitable instrument for measuring patient-centeredness poses a significant challenge in evaluating this essential aspect of care in Sri Lanka. The present study resulted in a culturally adapted and validated tool in Sinhala language to measure patient-centredness of care received by female partners of subfertile couples. Methods: The Patient Centredness Questionnaire-Infertility (PCQ-Infertility) was culturally adopted using a modified Delphi process, translated into Sinhala and assessed for its judgmental validity. The study was conducted September to December 2019. A cross-sectional study among 251 females attending the Subfertility Clinic at Teaching Hospital Mahamodara assessed the factor structure through exploratory factor analysis. The factor structure was confirmed with another cross-sectional study at the same setting among 250 females through confirmatory factor analysis. Test re-test reliability, internal consistency and inter-rater reliability were also assessed. Results: The validated PCQ-Infertility had 44 items with a seven-factor structure identified after exploratory factor analysis and confirmatory factor analysis with a combination of acceptable fit indices (SRMR of 0.079, CFI 0.862 and RMSEA 0.069). A Cronbach’s alpha value 0.761 assured high internal consistency. Test- retest and inter-rater reliability assessment gave satisfactory results with values exceeding 0.7 for all domains. Conclusion: Modified PCQ-Infertility is a valid and reliable instrument which can be used to assess patient centredness care received of subfertile females in Sri Lanka.

Developing and validating a Domain-specific Grit Scale for College Athletic Students

The aim of this study was to create and validate a ten-item Domain-specific Grit Scale for College Athletic Students (DGSCAS) to assess the level of grit among college athletic students. College athletic students from a single independent college located in a northern city in China (526 participants at time 1 and 589 participants at time 2) were assessed according to the scale. Various analyses were conducted in this study, including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and measurement invariance analysis across different sex and birthplaces. The results of the EFA revealed two factors: consistency of interests and perseverance of effort. The CFA results demonstrated acceptable fit indices (x2 = 160.048, df = 34, x2/df = 4.707, CFI = 0.983, TLI = 0.978, SRMR = 0.021, and RMSEA = 0.079). The scale exhibited satisfactory convergent validity and discriminant validity. The significant correlation of these factors with the Grit scale provided strong evidence of criterion-related validity. Measurement invariance analysis indicated that the scale performed consistently across different sex and birthplaces. Three limitations and corresponding recommendations were discussed, including sample heterogeneity, the lack of a unified test result as a criterion for predictive validity, and the cross-sectional design of the study. In conclusion, the DGSCAS is a practical and validated instrument that can be used to assess the level of grit among college athletic students in an educational context.

Time consistency of dynamic risk measures and dynamic performance measures generated by distortion functions

. The aim of this work is to study risk measures generated by distortion functions in a dynamic discrete time setup and to investigate the corresponding dynamic coherent acceptability indices (DCAIs) generated by families of such risk measures. First, we show that conditional versions of Choquet integrals are indeed dynamic coherent risk measures (DCRMs) and also introduce the class of dynamic weighted value at risk measures. We prove that these two classes of risk measures coincides. In the spirit of robust representations theorem for DCAIs, we establish some relevant properties of families of DCRMs generated by distortion functions and then define and study the corresponding DCAIs. Second, we study the time consistency of DCRMs and DCAIs generated by distortion functions. In particular, we prove that such DCRMs are sub-martingale time consistent, but they are not super-martingale time consistent. We also show that DCRMs generated by distortion functions are not weakly acceptance-time consistent. We also present several widely used classes of distortion functions and derive some new representations of these distortions.

Short Communication: Utility-Based Acceptability Indices

Short Communication: Utility-Based Acceptability Indices

Measurement of sustainable attitudes: a scale for business students

Purpose This study aims to present the development and validation of a scale to measure the attitudes of Latin American business students toward sustainable management practices in the economic, social and environmental dimensions. Design/methodology/approach Using a nonprobabilistic sample, the appreciation for sustainable practices in students (ASP-S) scale was administered to a total of 653 undergraduate and graduate business students in Argentina, Colombia, Mexico and Peru. A range of psychometric validity (construct, convergent and discriminant) and reliability criteria were applied. Findings Construct, convergent and discriminant validity was obtained from the ASP-S scale across all samples. During the internal validation process, two factors were found: systemic consciousness (ten items) and sustainable business leadership (nine items), both of which obtained acceptable reliability indices. The resulting structure is equivalent in all four countries. Originality/value The instrument can be applied by educators and learning assurance areas to diagnose and measure the effectiveness of pedagogical strategies used in sustainability courses taught at Latin American business schools. As a result, it has applications for curriculum design. As a valid and reliable instrument set in the context of regional business praxis, it can promote an understanding of sustainable behaviors and practices in future Latin American leaders.

Developing a Scale in the junction of Religiousness and Moral Disapproval of Pornography

The development process and validity and reliability studies of the "Moral Disapproval of Pornography Scale" (MDSS) are described in this study. Moral disapproval of pornography use, one of the three components of the Anti-Pornography Problems Associated with Moral Inconsistency (APPM) model, refers to the psychological difficulties created by individuals' pornography use that contradicts their moral beliefs about pornography. This incongruence is shown to have a moderating role between individual’s self-perception of addiction and their psychological well-being. In studies conducted abroad, it is seen that the phenomenon in question is examined with instruments consisting of moral and religious oriented items. These items were reconstructed according to the conditions of our country and turned into a scale that people with different religious beliefs and practices can easily answer. The exploratory factor analysis of the obtained scale was conducted with 634 participants. Subsequently, a confirmatory factor analysis of the scale was performed with a second sample of 580 individuals. The Cronbach's alpha coefficient for internal consistency was calculated as .862, indicating good reliability. The exploratory factor analysis revealed that 71% of the total variance was explained and the items loaded onto a single factor. In the confirmatory factor analysis, acceptable fit indices [χ2 / df = 1.81, RMSEA = .005, AGFI = 0.97, CFI = 0.99, GFI = 0.98, RMR = 0.02] were obtained. In conclusion, the Pornography Moral Disapproval Scale (PMDS) was found to be a valid and reliable measure.

Assessing general hospital doctors’ attitudes toward psychiatric care in multicultural settings

ObjectivePsychiatric care in general hospitals depends on collaboration with non-psychiatrist doctors. The Doctors’ Attitudes toward Collaborative Care for Mental Health (DACC-MH) is a two-factor scale designed to address this issue and validated in the UK in 2010. However, its applicability in contemporary, culturally diverse settings is unknown and therefore this study was aimed at determining its validity and consistency using data from our 2021 international study. Confirmatory and exploratory factor analyses were used, comparing results from our 2021 study (n = 889) with those from the 2010 UK study (n = 225).ResultsThe DACC-MH consultation subscale, but not the management subscale, aligned with data from our larger, international study. The 2-factor model failed the Chi-square goodness of fit test (χ2(19) = 53.9, p < 0.001) but had acceptable other fit indices. While the previously identified attitudinal difference between physicians and surgeons was replicated, measurement invariance for this result could not be established. Exploratory factor analysis suggested a 6-factor model, contrasting with the 2-factor model proposed in 2010 for the UK sample. The DACC-MH scale shows significant limitations when applied to a larger, international dataset. Cultural and generational differences in doctors’ attitudes appear relevant and should be considered in assessing barriers to psychiatric care in general hospitals.

Star-shaped acceptability indexes

We propose the star-shaped acceptability indexes as generalizations of both the approaches of Cherny and Madan (2009) and Rosazza Gianin and Sgarra (2013) in the same vein as star-shaped risk measures generalize both the classes of coherent and convex risk measures in Castagnoli et al. (2022). We characterize acceptability indexes through star-shaped risk measures and star-shaped acceptance sets as the minimum of a family of quasi-concave acceptability indexes. Further, we introduce concrete examples under our approach linked to Value at Risk, risk-adjusted reward on capital, reward-based gain-loss ratio, and monotone reward-deviation ratio.

Posttraumatic stress disorder symptomology as measured by PCL-5 and its relationships to resilience, hostility and stress among paramedics and social professionals.

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage=43.5±9.96years). Despite the acceptable fit indices gained with CFA when testing the original four-factor DSM-5 model of PCL-5, strong associations (r=0.69-0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three-factor version of the DSM-5 model of PCL-5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean-and variance-adjusted χ2=503.750 (df=270), comparative fit index=0.948, Tucker-Lewis index=0.939, root mean square error of approximation (90% confidence interval)=0.064 (0.055-0.073), weighted root mean square residual=1.024). Our analysis of the Hungarian version of PCL-5 contributes to the testing of a DSM-5-based questionnaire measuring posttraumatic stress disorder symptomology.

Development of the Hospital Nurses' Silence Behavior Scale

This study aimed to develop a scale to measure hospital nurses' silence behavior and examine its validity and reliability. A total of 52 preliminary items on hospital nurses' silence behavior were selected using a content validity test by seven experts on 53 candidate items derived from a literature review and in-depth interviews with 14 nurses. A total of 405 hospital nurses participated in a psychometric testing. Data analysis comprised item analysis, exploratory and confirmatory factor analyses, and convergent and discriminant validity tests. Pearson's correlation coefficient was used for assessing concurrent validity, and Cronbach's alpha was used for the reliability test. The final scale consisted of nine factors with 31 items, exhibiting acceptable model fit indices, convergent validity, and discriminant validity. The score of the entire scale was positively correlated with the 'Organizational Silence Scale (OSS)-the issues on which nurses remain silent' (r = .60, p < .001) and 'OSS-the reasons why nurses remain silent' (r = .68, p < .001). Cronbach's α of the scale was .92, and α of each subscale ranged from .71 to .90. The Hospital Nurses' Silence Behavior Scale is a useful tool for assessing multifaceted silence behavior among nurses. It can provide basic data for developing better communication strategies among nurses and other hospital staff.

Validity and reliability of the 9-item shared decision-making questionnaire (SDM-Q-9) among Indian oncology patients in a tertiary care hospital

BackgroundThe SDM-Q-9 is a widely used and reliable tool for assessing patient involvement in shared decision-making. However, there is a dearth of validated information regarding this tool among the Indian population. Therefore, the current study aimed to evaluate the validity and reliability of the Hindi version of the SDM-Q-9 questionnaire in Indian oncology patients. Methodology: This study was conducted between August 2022 to March 2023 at a tertiary cancer care hospital in India. The sample comprised 150 patients. The scale was initially translated into the Hindi language and later back-translated by experts. Item characteristics were measured using the difficulty index, corrected item-total item correlation, and internal consistency. Factor analysis was conducted using both exploratory factor analysis and confirmatory factor analysis to validate the scale in SPSS v.27 and IBM AMOS v.26. ResultsThe Cronbach alpha value was found to be significantly good (0.841), indicating high internal consistency. Additionally, the Kaiser-Mayer-Olkin value was 0.825, which suggested that the sample adequacy was satisfactory. Bartlett's test (x2 = 461.209 (df = 36), p = 0.000) also showed that the data were suitable for factor analysis. EFA resulted in an uni-factorial model extraction similar to the developed version, with acceptable model fit indices including CFI (0.861), GFI (0.891), AGFI (0.818), RMSEA (0.122), SRMR (0.119), and TLI (0.815). The CFA resulted in better model fit indices. ConclusionThe study suggests that the Hindi version of the SDM-Q-9 questionnaire is a suitable tool for measuring patient-reported involvement in clinical decision-making among Indian oncology patients.

Don Mariano Marcos Memorial State University Medical OutPatient Records Management System: A Prototype

Exploring a transformative solution is driven by the inefficiencies inherent in the traditional manual, paper-based outpatient record management system at Don Mariano Marcos Memorial State University (DMMMSU). This research introduces the Medical Out-Patient Records Management System (MORMS) to fill this gap. Developed through the software development lifecycle, this OMRMS optimally maintains outpatient records; therefore, it assists medical professionals in recording, organizing, and retrieving patient data effortlessly. Notably, statistical reports represent data trends that are an invaluable product. The overall approval of MORMS was unanimous during User Acceptance Testing (UAT), with each tested component receiving a 100 percent acceptability index. Based on this assessment, it can be concluded that there is a high likelihood of integrating the system into the daily processes of DMMMSU’s medical officers across all its three campuses because its usefulness is valued by them. Moreover, usability testing validates the functional practicality of MORMS with respect to the Computer System Usability Questionnaire subscales -system usefulness, information quality, and interface quality. Consistent median ratings of 1 for these scales indicate pragmaticity or practicability; dependability; precision and ease of use, which are some merits of this methodical tool. Consequently, not only gaining acceptance from users but also being highly usable makes MORMS effective in complying with various requirements set by different groups within DMMMSU’s medical staff.

Psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool

BackgroundHypertension is prevalent in China. Hypertensive patients suffer from many health problems in life. Hypertension is a common chronic disease with long-term and lifelong characteristics. In the long run, the existence of chronic diseases will affect the patient’s own health beliefs. However, people’s health beliefs about Hypertension are not explicit. Therefore, it is vital to find a suitable instrument to comprehend and improve the health beliefs of hypertensive patients, thus, better control of blood pressure and improvement of patient’s quality of life are now crucial issues. This study aimed to translate the Hypertension Belief Assessment Tool (HBAT) into Chinese and examine the psychometric properties of the Chinese version of the Hypertension Belief Assessment Tool in hypertensive patients.MethodsThis is a cross-sectional study. We translated the HBAT into Chinese and tested the reliability and validity of the Chinese version among 325 hypertensive patients.ResultsThe Chinese version of the scale contains 21 items. The Exploratory Factor Analysis (EFA) revealed six factors and explained 77.898% of the total variation. A six-factor model eventually showed acceptable fit indices in the Confirmatory Factor Analysis (CFA). With modified Confirmatory Factor Analysis, the fit indices were Chi-square/Degree of Freedom (CMIN/DF) = 2.491, Comparative Fit Index (CFI) = 0.952, Incremental Fit Index (IFI) = 0.952, Root-mean-square Error of Approximation (RMSEA) = 0.068, Tucker Lewis Index (TLI) = 0.941. The HBAT exhibits high internal consistency reliability (0.803), and the scale has good discriminant validity.ConclusionThe results suggest that the HBAT is a reliable and valid instrument for assessing the beliefs of Chinese hypertensive patients.

Pre-operative body shape concerns moderate excess weight loss trajectory in bariatric surgery patients: a 2-year longitudinal study

PurposeThe main research aim was to inspect whether pre-operative body shape concerns and discomfort as Body Shape Questionnaire (BSQ) scores moderate post-operative weight loss trajectory in bariatric patients.MethodsTwo studies were conducted. Study 1 analyzed cross-sectional data and verified the structural validity of the 34-item BSQ questionnaire on a sample of 327 candidates for bariatric surgery. Study 2 examined longitudinal data, with objective Body Mass Index (BMI) recorded every 6 months, from surgery intervention on, with 5 measurement occasions, from 111 patients who initially completed BSQ as bariatric surgery candidates and then underwent periodic medical post-operative follow-ups, over 2 years.ResultsIn Study 1, confirmatory factor analysis of a single-dimension model yielded acceptable fit indices and high internal consistency levels. Study 2 showed that post-operative excess BMI reduction trend was not linear and pre-operative BSQ scores moderated it, with a higher risk of weight regain in patients who initially were less concerned with their body shape.ConclusionsThe present findings support the structural validity of the BSQ questionnaire in bariatric candidates and call attention on the role of pre-operative body shape concerns on post-operative weight loss trajectories over 2 years, in accordance with a pathoplasty model. They suggest the need for systematic attention on perceived body image and psychological paths aimed to help bariatric patients regain positive attitudes towards their own body.Level of evidence III, well-designed cohort