Internal Consistency Analysis Research Articles

COPD empowerment scale: a scale development and validatıon study

Abstract Background The fact that COPD symptoms seriously affect daily life makes it different from other chronic diseases. The purpose of this study was to develop the COPD Empowerment Scale and test its psychometric properties. Methods This study, carried out with a methodological design, was carried out in a Chest Diseases Hospital in Istanbul, Turkey, between June 2023 and March 2024. A scale item pool was created by literature review and semi-structured interviews with COPD patients, and opinions were obtained from 16 experts. The draft scale, consisting of 55 items, was applied to 30 COPD patients as a pilot study. The draft scale was applied to 275 COPD patients and its psychometric properties were tested. The validity of the scale was evaluated by Content Validity Index (CGI) and exploratory and confirmatory factor analysis. Its reliability was evaluated by internal consistency analysis (Cronbach Alpha coefficient), item-total score correlations and test-retest analyses. Statistical significance level was accepted as p < 0.05. Results The KGI of the scale was found to be 0.97. The draft scale was transformed into a scale with five sub-dimensions and 31 items as a result of exploratory factor analysis. Cronbach’s Alpha value of the total scale is 0.896, and its sub-dimensions Cronbach’s Alpha values are; knowledge and understanding was found to be 0.731, access to health services was 0.816, self-efficacy was 0.719, symptom management was 0.842, and psycho-social coping was 0.728. Factor loadings of all items were 0.40 and above. As a result of confirmatory factor analysis, χ2 /df (2.59), RMSEA (0.076), NFI (0.92), NNFI (0.95), SRMR (0.03) and CFI (0.95) measurements are within the desired fit values. In the test-retest reliability study of the scale, the Pearson moment correlation coefficient was found to be rᵪᵪ=.996 (p<.01). Conclusions The COPD empowerment scale was found to be psychometrically valid and reliable. Key messages • The developed scale is a valid and reliable tool to determine the reinforcement needs of COPD patients. • The scale can be used to evaluate the effectiveness of empowerment initiatives.

The Attitude of Nursing Staff Towards Oral Healthcare for Care-Dependent Older Adults (ANOCO) Questionnaire: Development and Validation.

This study aims to report on the development and validation of the Attitude of Nursing staff towards Oral healthcare for Care-dependent Older adults (ANOCO) questionnaire. The development of the ANOCO questionnaire was performed in three stages between 2008 and 2019. In a first stage, domains related to oral healthcare attitudes were identified. Next, relevant statements per domain were formulated by a Delphi panel in two rounds, resulting in a questionnaire with 32 statements. In a final phase, this questionnaire was subjected to psychometric analysis, including an evaluation of the construct validity, an internal consistency analysis (Cronbachs alpha) and a principal component analysis. The questionnaire could significantly distinguish between known groups (dentists, nurses' aides, nursing students and nurses). Regarding internal consistency, Cronbach's alpha was 0.863 in the first sample (n = 361) and 0.843 in the second sample (n = 1051). Based on principal component analysis, 22 statements were retained. Four components with an eigenvalue of more than 1 explained 45% of the total variance. The ANOCO-22 questionnaire consists of 22 statements and is a valid tool to assess the changes or differences in the attitude of nursing staff towards oral healthcare for care-dependent older adults.

Sleep Quality in Parkinson Disease: Clinical Insights and PSQI Reliability Assessment

AbstractSleep disturbances are prevalent in Parkinson disease (PD), encompassing a spectrum from parasomnias like REM sleep behavior disorder to symptoms of sleep-wake cycle dysregulation, such as insomnia and daytime sleepiness. This research investigates sleep quality in PD patients compared with a matched healthy control group and explores the relationships between PD clinical characteristics and sleep parameters. Additionally, the study assesses the reliability of the Pittsburgh Sleep Quality Index (PSQI) for PD patients by examining internal consistency. The study comprises 52 participants, 27 in the PD group and 25 in the healthy control group, matched for sex and age. Sleep quality revealed that PD patients experienced significantly poorer sleep quality than the control group (p = 0.009). Weak correlations were found between PSQI scores and the modified Hoehn and Yahr scale (p = 0.062), with no correlation observed with the daily equivalent dose of levodopa (L-DOPA). The prevalence of poor sleep quality (PSQI score > 5) was 85.1% for PD patients and 68% for the control group. The internal consistency analysis of the PSQI yielded a Cronbach's α of 0.588 for the PD group. While the PSQI demonstrates utility in detecting general sleep abnormalities and gauging patient perceptions of sleep quality in PD, its limitation as a global score is emphasized. The index prioritizes sleep habits and may not fully capture important sleep disorders in this population. These findings underscore the complex relationship between PD and sleep quality, suggesting the need for a comprehensive approach to assess and address sleep disturbances in PD patients.

Validity and Reliability Testing of the Turkish Version of the Self-Acceptance Scale for Pregnant Women

Objective: This study was conducted to adapt the Self-Acceptance Scale for Pregnant Women (SAS-PW), which was developed in Brazil, to Turkish and test the psychometric properties of its Turkish version. Method: This methodological study was carried out with 576 pregnant women who presented to the pregnancy outpatient clinics of a Research and Training Hospital in northern Turkey between December 2021 and April 2022. The validity of the Turkish version of SAS-PW was tested by conducting linguistic, content, and construct validity analyses, while its reliability was tested by conducting internal consistency and test-retest analyses. Results: According to the results of the exploratory factor analysis, the factor load values of the items and the rates of the total variance in scale scores explained by the factors were sufficient. The confirmatory factor analysis results demonstrated that the goodness-of-fit indices of the scale were within suitable ranges. The 2-factor and 10-item construct of the original SAS-PW was confirmed based on the factor analyses. The item-total score correlations of the scale were found sufficient, and the total Cronbach’s alpha coefficient of SAS-PW was determined to be 0.933. The test-retest analysis of the scale scores revealed a strong correlation between the scores of the two implementations. Conclusions: The Turkish version of SAS-PW is a valid and reliable measurement instrument to evaluate the self-acceptance levels of pregnant women in Turkish society.

Development and validation of the chemotherapy adherence assessment scale (CAAS).

Adherence to chemotherapy regimens is crucial for achieving optimal treatment outcomes in cancer patients. However, measuring adherence remains a significant challenge. This study aimed to develop and validate a comprehensive self-report tool for assessing chemotherapy adherence. The Chemotherapy Adherence Assessment Scale (CAAS) was developed through a multi-stage process involving literature review, expert input, and pilot testing. Face validation was conducted with 23 subject experts, and content validity was assessed using the Content Validity Index (CVI). The CAAS was pilot-tested on 28 cancer patients undergoing chemotherapy. Psychometric properties were evaluated through internal consistency analysis (Cronbach's alpha) and Exploratory Factor Analysis (EFA). Face validation revealed 85% agreement among experts regarding grammar, clarity, and content. The CVI was 0.81 for individual items and 0.83 for the overall scale, indicating good content validity. Cronbach's alpha was 0.789, demonstrating strong internal consistency. The EFA yielded a robust five-factor structure, explaining 94.63% of the total variance. Most items exhibited strong factor loadings (>0.7) and high communalities (>0.7), supporting the construct validity of the CAAS. The CAAS demonstrated robust psychometric properties, including good content validity, high internal consistency, and a well-defined factor structure capturing key dimensions of chemotherapy adherence. The CAAS represents a valuable contribution to adherence assessment in oncology settings, with potential applications in clinical practice and adherence interventions.

Measuring fidelity to manualised peer support for people with severe mental health conditions: development and psychometric evaluation of the UPSIDES fidelity scale

BackgroundPeer support workers provide support for people experiencing mental health conditions based on their own lived experience of mental health problems. Assessing fidelity to core ingredients of peer support is vital for successful implementation and intervention delivery. Modifications to its implementation are needed when scaling up to different socio-economic settings, raising further uncertainty about fidelity. As part of a large multi-centre study on peer support called Using Peer Support In Developing Empowering Mental Health Services (UPSIDES), we developed and evaluated the psychometric properties of the UPSIDES Fidelity Scale.MethodsWe constructed the fidelity scale based on an initial item pool developed through international expert consultation and iterative feedback. Scale refinement involved site-level expert consultation and translation, resulting in a service user-rated 28-item version and a peer support worker-rated 21-item version assessing receipt, engagement, enactment, competence, communication and peer support-specific components. Both versions are available in six languages: English, German, Luganda, Kiswahili, Hebrew and Gujarati. The scale was then evaluated at six study sites across five countries, with peer support workers and their clients completing their respective ratings four and eight months after initial peer support worker contact. Psychometric evaluation included analysis of internal consistency, construct validity and criterion validity.ResultsFor the 315 participants, item statistics showed a skewed distribution of fidelity values but no restriction of range. Internal consistency was adequate (range α = 0.675 to 0.969) for total scores and all subscales in both versions. Confirmatory factor analysis indicated acceptable fit of the proposed factor structure for the service user version (χ2/df = 2.746; RMSEA = 0.084) and moderate fit for the peer support worker version (χ2/df = 3.087; RMSEA = 0.093). Both versions showed significant correlations with external criteria: number of peer support sessions; perceived recovery orientation of the intervention; and severity of illness.ConclusionsThe scale demonstrates good reliability, construct and criterion validity, making it a pragmatic and psychometrically acceptable measure for assessing fidelity to a manualised peer support worker intervention. Recommendations for use, along with research and practical implications, are addressed. As validated, multi-lingual tool that adapts to diverse settings this scale is uniquely positioned for global application.Trial registrationISRCTN, ISRCTN26008944. Registered on 30 October 2019.

The Chinese version of the Nursing Student Academic Resilience Inventory: A validity and reliability study

AimTo translate and adapt the Nursing Student Academic Resilience Inventory (NSARI) into Chinese and assess its validity and reliability among Chinese nursing students. BackgroundNursing students frequently encounter stress during their clinical education and academic resilience is an important skill to help students withstand stress. The NSARI is a valid and reliable tool for assessing the level of academic resilience of nursing students during clinical practice. Currently, there is no valid and reliable measurement tool to assess academic resilience for nursing students in China. DesignA descriptive, methodological and cross-sectional design was used. MethodThis study was conducted on 600 nursing students in Northeast China. A socio-demographic form, the Chinese version of the NSARI and the nurse resilience scale were used for data collection between May to November 2023. The exploratory factor analysis and confirmatory factor analysis samples comprised 300 students, respectively, to test the structural validity of the inventory. In addition, internal consistency and invariance analyses were conducted to assess the reliability of the inventory. ResultsThe Chinese version of NSARI comprises 24 items separated into six dimensions. Exploratory factor analysis extracted six factors, with a cumulative variance contribution rate of 71.908%. Confirmatory factor analysis showed a satisfactory fit. Cronbach’s alpha coefficient for the internal consistency of the total inventory was 0.939 with a test-retest stability reliability value of 0.957. ConclusionThe Chinese version of NSARI is a valid and reliable measurement tool for assessing the level of academic resilience of nursing students during clinical placement.

Cross-Cultural Adaptation and Pilot Psychometric Validation of the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-Sexual Health (EORTC QLQ-SH22) Scale, Moroccan Arabic Version.

The Sexual Health Scale (QLQ-SH22) is the only cancer-specific measure of sexual health. It has never been translated into Arabic. In order to envisage effective healthcare strategies that improve sexual quality of life, the validation of the Moroccan version of this scale is a crucial step in exploring the influence of cancer and its treatment on patients in the Moroccan context. In this regard, this study aimed to validate a Moroccan Arabic version among patients with cancer. A total of 280 Moroccan patients with cancer participated in this study from August 2022 to April 2023. The translation and cross-cultural adaptation of the QLQ-SH22 was performed following the EORTC guidelines. Psychometric validation was explored using the reliability of internal consistency, test-retest reliability, and confirmatory factor analyses (CFA). The analysis revealed a greater internal consistency for both sexual satisfaction (α = 0.83) and sexual pain (α = 0.86). The intraclass correlation coefficient indicated an excellent level of test-retest reliability (from 0.925 to 0.993). The CFA demonstrated high-performing model fit indices (χ2/df = 1.17, SRMR = 0.05, RMSEA = 0.035, GFI = 0.94, CFI = 0.99, TLI = 0.99, IFI = 0.99, NFI = 0.94). The concurrent validity between the QLQ-C30 and QLQ-SH22 confirmed a strong correlation between the fatigue scales in both questionnaires (r = 0.69). This version showed good discrimination between known groups. The QLQ-SH22 Moroccan Arabic version has demonstrated a high level of reliability and validity, and therefore it is now ready for use.

20대 학습자의 학업걱정상태척도 개발 및 타당화

Objectives The purpose of this study is to develop and validate a scale of learners’ worry arising in the academic situation, to examine the psychometric properties of the developed scale. Methods To this end, we developed the Academic Worry State Questionnaire(AWSQ) and conducted internal consistency analysis and exploratory factor analysis on 208 learners in their 20s, and derived the main factors. Subsequently, we performed confirmatory factor analysis on an independent sample of 207 to evaluate the model fit. We also examined the discriminant validity, convergent validity, and criterion validity through correlation analysis between the developed Academic Worry State Questionnaire and related variables. Results Using the estimation sample of 208, the final 1-factor scale with 9 items was derived, demonstratinga high internal consistency, exceeding .90. Confirmatory factor analysis on the 207 validation sample showed good fit with CFI .978, TLI .970, RMSEA .067, and SRMR .035. Correlation analysis with related variables showed that the scale had convergent validity as it had statistically significant positive correlations with the Penn State Worry Questionnaire(PSWQ) scale and fear of failure. On the other hand, the scale had discriminant validity as it had significant negative correlations with trait academic self-efficacy and state academic self-efficacy. Criterion validity was also confirmed, as the scale showed significant positive correlations with the subscales of the academic exhaution scale and significant negative correlations with Conclusions The scale developed in this study has potential clinical significance for future use in educational or counseling interventions. The study concludes by discussing the implications and limitations of the study.

Factors influencing quality of processing in EMDR therapy.

This study presents a preliminary analysis of a new instrument oriented at the analysis of processes in EMDR trauma therapy, the Processing Difficulties Scale (PDS). This scale includes 17 items described by experienced EMDR consultants and practitioners as indicative of problems during memory reprocessing. The proposed factorial solution based on four factors explains a total variance explained of 55% and an adequate goodness of fit, based on the proposed indices: RMSEA = 0.07; TLI = 0.91; CFI = 0.95. Table 1 shows the factorial loads for each of the items. The first factor includes 5 items (7, 8, 9, 10, 11), the second factor includes 6 items (13, 14, 25, 27, 28, 31), the third factor includes 3 items (3, 16, 22) and the fourth factor includes 3 items (19, 23, 24). Confirmatory analysis confirms the factorial solution proposed in the exploratory analysis factor and based on four factors with 17 items. The analysis of internal consistency from Cronbach's alpha and the Omega index shows good internal consistency: Factor 1 (good processing; α = 0.92; ω = 0.94), Factor 2 (lack of generalization and/or absence of changes; α = 0.87; ω = 0.90), Factor 3 (poor emotional processing; α = 0.83; ω = 0.85) an Factor 4 (loss of dual attention; α = 0.82; ω = 0.83). In the case of the total scale, both coefficients exceeded 0.90, with an alpha of 0.92 and an Omega of 0.94. The convergent and discriminant validity criteria were estimated by calculating correlations, exploring the relationship between the factors resulting from the final result, the global severity index (GSI) of the SCL-90 and the level of improvement (NGS). These statistical analyses showed good levels of convergent and discriminant validity for all final factors. The PDS may offer a different perspective to analyze the controversy between clinicians and researchers about the need of a preparation phase in patients with complex early traumatization, dissociative symptoms and/or emotion dysregulation, and the different results in specific research around this topic. Exploring the problems in processing in a transdiagnostic way, in a preliminary analysis, we found that the number of early traumatic events measured with the ACE correlates positively with indicators of a loss of dual attention, while emotional dysregulation measured with the DERS does not predict poor processing. Finally, the dissociation measured with the DES seems to correlate positively with the indicators of a loss of dual attention during processing, not seeming to predict poor processing but did show a negative correlation with the indicators of good general processing. These results partially support the findings of some authors on the involvement of certain variables in the processing of traumatic memories, and it may be interesting to evaluate processing styles and their relationship with various indicators, to develop specific interventions in phase 2 of EMDR therapy, thus improving clinical interventions.

Translation and validation of the Indonesian version of the chronic otitis media questionnaire-12

Chronic suppurative otitis media (CSOM) is a pathological disorder affecting the ear, characterized by a persistent and long-lasting middle ear infection accompanied by the absence of an intact tympanic membrane. Multiple measures can be employed to evaluate the quality of life among patients with CSOM. One such instrument is the chronic otitis media questionnaire-12 (COMQ-12), which has demonstrated satisfactory levels of validity and reliability. The utilization of the COMQ-12 questionnaire has the potential to improve the quality of life experienced by CSOM patients. This study aimed to evaluate the validity and reliability of the Indonesian adaptation instrument of the COMQ-12 in patients with CSOM in the Otorhinolaryngology department of multiple hospitals in Yogyakarta. The study was conducted from February to July 2023. The study comprised 48 participants, consisting of 16 males and 32 females. The adapted Indonesian version of the COMQ-12 instrument demonstrates validity and reliability in assessing patients' quality of life with CSOM, as evidenced by a statistically significant r-value of 0.2353. The internal consistency analysis reveals that Cronbach's α coefficient is 0.868. The Indonesian adaptation of the COMQ-12 demonstrates validity and reliability as an assessment tool for measuring the health-related quality of life in patients diagnosed with CSOM.

Online Psychometric Performance of the Athens Insomnia Scale among Colombian People

Abstract Introduction The Athens Insomnia Scale (AIS) has shown acceptable performance in face-to-face applications. However, knowledge about AIS performance in online applications could be improved. Objective The study aimed to perform confirmatory factor, internal consistency, and differential item functioning analyses of AIS in two Colombian online samples. Material and methods Two samples were recruited online at different times (n = 700, M = 37.05, SD = 12.7 and n = 292, M = 60.4, SD = 17.6). Separated confirmatory factor analyses and Cronbach’s alpha and McDonald’s omega were computed for each factor. Results The data adjusted better for the AIS two-dimensional model in the general and clinical populations. Excellent internal consistency was observed among the general population sample and clinical sample. Conclusions The AIS shows a two-dimensional structure and high internal consistency in two online samples in Colombia. Corroboration of these findings in other samples is necessary.

Validation of the Work-Related Quality of Life Scale in Rehabilitation Health Workers: A Cross-Sectional Study.

Work-related quality of life (WRQoL) is a multidimensional concept related to life satisfaction. Evaluating WRQoL is essential in healthcare settings since employee satisfaction affects patient service quality. Only a few studies have focused on the quality of life of rehabilitation health workers. We aimed to validate the Italian version of the WRQoL scale on a population of rehabilitation health professionals; the secondary objective was to investigate the work-related quality of life of professionals concerning the work settings in which they operate. Participants were recruited from January 2022 to December 2023 according to specific inclusion criteria. Questionnaires were administered through an online survey requiring also personal employment data, and together with the SF-12 questionnaire, a test-retest was performed on 30 therapists. Reliability was assessed with Cronbach's alpha, test-retest stability through intraclass correlation coefficient (ICC), and concurrent validity was calculated using Pearson's correlation. We enrolled 284 individuals. Internal consistency analysis showed statistically significant results: Cronbach's alpha was > 0.70; construct validity analyses revealed statistically significant data for total scores and subscales, compared to SF-12 scores. The WRQoL scale is a valid and reliable tool to assess the quality of working life of rehabilitation professionals.

Development of a scale for measuring psychosocial vulnerability in disaster-prone areas

IntroductionDisaster vulnerability is a complex concept influenced by both natural forces and societal factors, including psychosocial aspects that shape an individual's resilience to natural hazards. Despite technological advancements, assessing psychosocial vulnerability remains challenging, necessitating specialized scales. This study attempted to develop a psychosocial vulnerability assessment scale, recognizing the intricate interplay of physical, psychological, and social factors. MethodsThe study was conducted in two disaster-prone wards in Cuttack, India, susceptible to cyclones, earthquakes, and floods. The scale development process involved two stages: instrument design and judgmental evidence. During the instrument design phase, qualitative data on psychosocial vulnerabilities were gathered through Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). These insights led to the generation of 44 items, which were subsequently refined to 35 items through expert consultation. The judgmental evidence phase included content validity assessment, internal consistency analysis, and test-retest reliability estimation. Exploratory Factor Analysis (EFA) identified the instrument's factor structure, with items retaining factor loadings exceeding 0.4. Data collection involved 400 individuals selected through multistage sampling, with strict adherence to ethical considerations. ResultData collected in the initial instrument design stage revealed key psychosocial vulnerability themes. These themes informed the creation of a 35-item scale categorized into three domains: Physical, social, and psychological vulnerability. The instrument underwent rigorous validation processes, demonstrating strong content validity agreement among experts. Internal consistency analysis revealed good reliability, as indicated by the Kuder-Richardson coefficient (KR20 = 0.904). Test-retest reliability further established the stability of responses over time, with an ICC of 0.82. EFA confirmed the scale's three-factor structure, explaining 60 % of the variance. After removing three items with low factor loadings, the scale proved reliable and valid, effectively categorizing vulnerabilities into these distinct domains. ConclusionThe scale developed in this study offers a comprehensive tool for understanding the unique challenges people living in disaster-prone areas face. It addresses the often-overlooked psychosocial components of vulnerability, filling a critical gap in existing research and measurement scales. Its application helps in planning psychosocial interventions and improving disaster risk reduction strategies.

Validity of the Musculoskeletal Tumor Society Score for lower extremity in patients with bone sarcoma or giant cell tumour of bone undergoing bone resection and reconstruction surgery in hip and knee

BackgroundThe Musculoskeletal Tumor Society Score (MSTS) is widely used to evaluate functioning following surgery for bone and soft-tissue sarcoma. However, concerns have been raised about its content validity due to the lack of patient involvement during item development. Additionally, literature reports inconsistent results regarding data quality and structural validity. This study aimed to evaluate content, structural and construct validity of the Danish version of the MSTS for lower extremity (MSTS-LE).MethodsThe study included patients from three complete cohorts (n = 87) with bone sarcoma or giant cell tumour of bone who underwent bone resection and reconstruction surgery in hip and knee. Content validity was evaluated by linking MSTS items to frameworks of functioning, core outcome sets and semi-structured interviews. Data quality, internal consistency and factor analysis were used to assess the underlying structure of the MSTS. Construct validity was based on predefined hypotheses of correlation between the MSTS and concurrent measurements.ResultsContent validity analysis revealed concerns regarding the MSTS. The MSTS did not sufficiently cover patient-important functions, the item Emotional acceptance could not be linked to the framework of functioning, the items Pain and Emotional acceptance pertained to domains beyond functioning and items’ response options did not match items. A two-factor solution emerged, with the items Pain and Emotional acceptance loading highly on a second factor distinct from functioning. Internal consistency and construct validity showed values below accepted levels.ConclusionThe Danish MSTS-LE demonstrated inadequate content validity, internal consistency, and construct validity. In addition, our analyses did not support unidimensionality of the MSTS. Consequently, the MSTS-LE is not a simple reflection of the construct of functioning and the interpretation of a sum score is problematic. Clinicians and researcher should exercise caution when relying solely on MSTS scores for assessing lower extremity function. Alternative outcome measurements of functioning should be considered for the evaluation of postoperative function in this patient group.

Validation and Adaptation of the Spanish Version of Cancer Survivors’ Unmet Needs survey (CaSUN-MX) for Use in the Mexican Adult Oncology Population

Introduction. Cancer survivorship in Mexico is a research topic that is still in its infancy. No specific studies have been found on the needs of this population, meaning that there are no validated scales in the Mexican population measuring the needs of cancer survivors. Objective. To validate and adapt the Cancer Survivors’ Unmet Needs survey, Spanish version (CaSUN-Mx) for use in the Mexican adult oncology population. Method. One hundred and eighty participants answered the questionnaire (CaSUN-S). For the analysis, the study was divided into three phases: content validity, construct validity, and internal consistency analysis. Results. The final version of the adapted questionnaire (CaSUN-Mx) has 34 items and one open question. It was divided into five factors with a total Cronbach’s Alpha of .95 and a value of over .85, in all the subscales (psychological care, comprehensive and collaborative care, practical and information needs, and those associated with effects. Discussion and conclusion. The CaSUN-Mx questionnaire has content validity because it has been adequately linguistically and culturally adapted, and construct validity because of its factorial structure, and reliability, making it suitable for use in the Mexican adult oncology population.

Development and psychometric evaluation of a pneumatic tourniquet work standards scale

ObjectivePneumatic tourniquets are among the most essential equipment for controlling bleeding in orthopedic surgeries. However, incorrect application of pneumatic tourniquets is accompanied by many hazards and complications for patients. Evaluation of surgical teams’ use of pneumatic tourniquets and establishment of protocols can play an important role in improving patient safety, minimizing risks, and increasing the lifetime of this equipment. Accordingly, the present study was conducted to develop and assess the psychometric properties of a pneumatic tourniquet work standards scale.MethodsThe present study is a methodological work carried out in two stages. In the first stage, an initial version of the scale was developed based on existing research and panel reviews. In the second stage, the psychometric properties of the scale were tested in terms of face validity (measured qualitatively and quantitatively), content validity (measured qualitatively and quantitatively), item analysis, construct validity, and reliability (internal consistency and stability).ResultsThe initial version of the scale consisted of 91 items. After several meetings of the research team, the number of items decreased to 81. In the course of face and content validity testing, 40 items were eliminated, leaving 41 items on the scale when it entered the construct validity testing stage. For evaluation of construct validity, a sample of 300 operating room nurses was recruited. The Exploratory Factor Analysis (EFA) results showed a structure supported by seven factors and 41 items. The reliability of the scale was confirmed by internal consistency analysis, with a good Cronbach’s alpha (0.85), and test–retest analysis, with good values of ICC (0.95).ConclusionThe present instrument is a reliable and valid scale which fills the gap in assessment of surgical team members’ use of pneumatic tourniquets. The developed scale can be employed by researchers and managers of medical centers to identify hazards in applying pneumatic tourniquets and devise educational programs to eliminate or reduce the existing issues.

Development and validation of a new questionnaire for the assessment of patients with diabetic foot disease: The Diabetic Foot Questionnaire (DiaFootQ)

BackgroundThe epidemiology data and global burden of diabetic foot disease underscores the need for effective prevention strategies, which requires an early diagnosis. Patient-reported outcome measures are instruments based on a simple format, which favours their application. Currently, there is an absence of instruments with a broad enough scope to capture the diverse aspects involved in diabetic foot disease. ObjectivesTo develop a questionnaire for the assessment of patients with diabetic foot disease and carry out an analysis of its validity and reliability. MethodsThe study was developed in two stages. Stage 1: the Delphi Panel was composed of 22 experts. The questionnaire is made up of 25 questions selected, after three rounds, from an initial sample of 68 questions. Stage 2: A validation study was performed. With a sample of 273 subjects, an exploratory factor analysis and an analysis of internal consistency, items response, and validity were carried out using the Diabetes Quality of Life, SF-12v2, Foot Function Index and EuroQol EQ5D questionnaires. Measurements of error and sensitivity to change were also analyzed. ResultsA 25-item questionnaire (DiaFootQ) was developed. It comprised two dimensions: 1) lifestyle and function; and 2) footwear and foot self-care. Sample (n=273) mean age was 69.77 years (±11.08). The internal consistency of DiafootQ was α=0.916, and item response values were ICC=0.862–0.998. External validity correlation levels ranged from r=0.386 to r=0.888. ConclusionDiaFootQ was developed. Integrating the main aspects involved in diabetic foot disease could help to detect more accurately the risk or severity of these patients. DiaFootQ is a well-structured, valid, and reliable tool whose use should be promoted in clinical and research settings.

Validity and Reliability of the 21st-Century Skills Scale.

Background Purpose: This study was carried out to assess the validity and reliability of the Turkish version of the 21st-Century Skills Scale in Nursing Students. Methods: It is a methodological type of research. In the validity study of the scale, language validity, content validity, and structure validity were examined. Internal consistency analysis was performed in the reliability study. Results: According to the exploratory factor analysis, the total variance explained by the eight-factor structure was calculated as 57.15%. Items 63, 62, 60, and 15 were removed from the scale, as they did not contribute to any factor. Confirmatory factor analysis showed that the model was statistically significant and valid (χ2 /df = 2.255). Conclusions: The results of this research indicate that the 21st-Century Skills Scale is a valid scale with 8 sub-dimensions and 59 items in Turkish society and can be used reliably to determine the 21st-century skills of nursing students.

Patient Reported Outcome Measures used in Surgical Evaluation of Obstructive Sleep Apnea: A Systematic Review.

To identify patient-reported outcome measures (PROMs) used to measure adult obstructive sleep apnea (OSA)-related quality of life in sleep surgery and analyze key psychometric properties in the original design and development of each PROM. PubMed, Web of Science, Embase, PsychINFO, and CINAHL. A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Disease-specific instruments assessing sleep-related quality of life that were used in sleep surgery studies and validated in patients with sleep disorders were included. The Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) criteria were used to evaluate methodological quality. A total of 2494 abstracts were retrieved, and 216 underwent full-text review. Seven PROMs assessing sleep-related quality of life were identified. Only one (14%) PROM (SAQLI) was developed using both patient and physician input, and none were rated as "adequate" for content validity. Two PROMs utilized patients with sleep-disordered breathing during content development and none specifically queried patients considering surgery. Six (86%) PROMs demonstrated "very good" analysis of internal consistency per COSMIN criteria, and six (86%) included data on test-retest reliability. Several PROMs are utilized in sleep-related quality-of-life assessments for patients treated with OSA surgery. The measurement properties of these PROMs are of variable quality, and notably, no PROMs meet adequate quality measurements for content validity. New and updated PROMs for OSA-related quality of life should consider input from sleep surgery patients and providers. Laryngoscope, 2024.