Compliance Behavior Research Articles

Reducing strategic uncertainty in transportation networks by personalized routing advice: A route-choice laboratory experiment

One fundamental reason causing traffic flow instability and the difficulties in predicting traffic conditions is strategic uncertainty. This paper experimentally investigated how routing advice influenced strategic uncertainty and analyzed compliance behavior and decision time that might affect strategic uncertainty. Subjects participated in a route-choice game in which they were required to choose among three routes from one origin to one destination. Two routing advice strategies, user-optimal recommendation (UOR) and system-optimal recommendation (SOR), taking into account subjects’ choice inertia, were investigated. The experimental results indicated that (i) UOR could reduce strategic uncertainty and stabilize traffic flow, whereas SOR was counterproductive, (ii) subjects were more likely to comply with UOR compared with SOR and preferred to follow the advice with the same choices as the previous round rather than the route switching advice, (iii) the subjects with faster decisions (intuition) had higher compliance rates and lower travel costs than those with slower decisions (deliberation). Our experimental findings suggest that fairness and psychological factors are crucial in route choice, providing valuable guidance in designing personalized advanced traveler information systems.

The association between workplace physical environment and nurses’ safety compliance: A serial mediation of psychological and behavioral factors

AimThis study describes Jordanian intensive care unit nurses' satisfaction with their physical environment and investigates the association between workplace physical environment and nurses' safety compliance. Additionally, the study offers serial mediation analyses of psychological and behavioral factors between satisfaction with the workplace physical environment and nurses’ safety compliance. IntroductionCompliance with safety measures is a vital indicator of safety performance, as less compliance directly reflects undesirable safety outcomes among nurses, like occupational accidents, injuries, and fatalities. Social cognitive theory and the safety triad model contribute to understanding safety compliance behaviors to safety procedures. Thus, enhancing safety compliance in healthcare organizations remains a challenge and concern. MethodsA quantitative research method was used based on cross-sectional and descriptive data from eight governmental hospitals in Jordan. The population included all intensive care unit nurses in the Ministry of Health's hospitals (n = 1104). A cluster sampling technique selected 285 nurses to participate. Empirical results were obtained through structural equation modeling (i.e., Smart PLS-SEM), which has become popular in this kind of research. ResultsThe mean of Jordanian ICU nurses' satisfaction with the workplace physical environment was 3.36, which is moderate. Although the Smart PLS findings did not support the direct association between the workplace physical environment and nurses' safety compliance, serial mediation of safety participation in the workplace physical environment and nurses’ safety compliance and perceived safety management commitment confirm the indirect association in the study model. ConclusionThis study fills a gap in available safety and nursing literature, especially when considering the scarce studies that investigated the physical elements in the workplace and both safety compliance and safety participation. The findings are valuable for academicians, health providers, and policymakers and may trigger creative ideas and interventional solutions to improve nurses’ safety compliance in healthcare organizations.

Taxpayer Compliance Behavior: A Qualitative Analysis Of The Impact Of Tax Incentives, Income Levels, And Sanctions

This qualitative study investigates taxpayer compliance behavior by examining the influence of tax incentives, income levels, and sanctions. Through in-depth interviews and thematic analysis, the research explores the motivations and decision-making processes behind taxpayers' compliance or non-compliance. The findings shed light on the complex interplay between tax policy measures and individual taxpayer behavior, providing valuable insights for policymakers and tax authorities.

Factors influencing health worker compliance in implementing patient safety goals in Indonesia: Systematic review

The compliance rate of health workers in patient safety is not fully good at 68.7% and the implementation of patient safety in Indonesia is not optimal at 74.2% whereas in 2016 in Indonesia there were still 31 cases related to patient safety. To determine the factors that affect the compliance of health workers in the implementation of patient safety goals using a systematic review approach. This study uses a systematic review method from 9 studies using a quantitative approach commonly called a meta-analysis. The search for the source of this research data uses PRISMA flow charts from several databases such as Google Scholar, garuda portal, ProQuest, and Elsevier. Where published in the last 10 years (2013-2023). 25 variables were the same in the study between one researcher and another, namely age, gender, marital status, number of dependents, length of work, nurse knowledge, nurse motivation, supervision, nursing, organizational influence, educational status, compliance behavior, ability, supervisor support, fellow nurse support, workplace comfort, employment status, motivation, perception, nurse compliance, 6 patient safety goals, patient safety culture, patient identification, patient safety events, and patient fall prevention. The average P-Value value is 0.180, the minimum value of P-Value = 0.000, and the maximum value of P-Value = 0.995. 8 dominant factors influence health workers in implementing patient safety goals. 8 dominant factors influence health workers in implementing patient safety goals, namely knowledge, length of work, nurse work motivation, nurse perception, stress level and workload, nurse compliance, organizational influence, and supervisor support.

Exploring the relationships among safety leadership, safety climate, psychological contract of safety, risk perception, safety compliance, and safety outcomes

BackgroundRecently, two types of safety compliance behaviors including deep compliance and surface compliance were differentiated. The current study aimed to investigate the relationships among safety leadership, safety climate, psychological contract of safety (PCS), risk perception, and deep compliance and surface compliance behavior of workers. In addition, the effects of both deep and surface compliance on safety outcomes were considered.MethodsWorkers’ perceptions in terms of safety leadership, safety climate, PCS, risk perception, deep compliance, and surface compliance were measured by appropriate questionnaires. Three questions were asked to measure undesired safety outcomes. Structural equation modeling and correlation analysis were applied to examine the research model and relationships among variables.Results and discussionThe results of the current study showed that deep compliance was positively predicted by safety leadership, safety climate, and PCS and negatively predicted by risk perception. Surface compliance was positively predicted by safety leadership and safety climate and negatively predicted by risk perception. Surface compliance is not significantly predicted by PCS. With regard to the adverse safety outcomes, the results showed that both deep and surface compliance were negatively associated with adverse safety outcomes, however, deep compliance had a stronger negative correlation with adverse safety outcomes than surface compliance.

Conducting formative research during a pandemic threat to inform the development of an obesity prevention social and behaviour change communication strategy in Tonga.

The global epidemic of obesity is overtaking many parts of the world with the Pacific Islands at particular risk. Tonga population surveys identify significant increases in overweight and obesity with Social and Behaviour Change Communication (SBCC) offering opportunities for curbing the rise in non-communicable diseases. Formative research was conducted during the Covid-19 pandemic to assess stakeholder and program beneficiary needs and wants toward an obesity prevention SBCC strategy in Tonga. Semi-structured interviews with 17 key informants and 18 focus group discussions (N = 168) were conducted in Tongatapu. Data analysis was conducted on Nvivo 2020 qualitative software with desk research of secondary data supporting in-field findings. Potential barriers to behavioural compliance included social/cultural norms, poor attitudes; low motivation and capability; and vulnerabilities of gender and other social determinants. Opportunities included the Tongan collective mindset and the desire for greater social interaction and fun. Strong political will to affect change was apparent with the need to consider targeting to youth, social mobilisation of communities through empowering messaging, and an integrated range of activities. Co-design in the formative research process was able to be fostered via online communication processes to overcome the challenges of Covid-19 travel restrictions. The innovative approach provided a number of learnings including identification of national and regional priorities and improved efficiencies in SBCC planning, implementation and evaluation. SO WHAT?: Formative research adopting co-design approaches with stakeholders and program beneficiaries can provide optimal engagement and ownership in the SBCC strategy including insights into messaging approaches.

Perubahan Perilaku Masyarakat Terhadap Kepatuhan Menjalankan Protokol Kesehatan Setelah Dilakukan Penegakan Disiplin Oleh Satpol PP

This study aims to provide a description of changes in people's behavior towards compliance with health protocols after discipline is enforced by Satpol PP based on Tegal Regent Regulation No. 62 of 2020. In this study, the approach used was a combination of qualitative and quantitative. A qualitative approach is used to describe whether the enforcement of discipline carried out by Satpol PP related to compliance with health protocols results in changes in community behavior, while the quantitative approach used is hypothesis testing on signs used to analyze changes in community behavior compliance in carrying out health protocols after enforcement. disciplined by Satpol PP, while in order to ensure whether or not there is a change in the state of compliance with community behavior in carrying out health protocols, before and after treatment (before and after treatment research design) a hypothesis testing method on growth is used using the Mac Nemar change test. The enforcement of discipline carried out by the Satpol PP on compliance with community behavior in carrying out health protocols as an effort to overcome the spread of Covid 19 in Tegal Regency is able to make changes to people's behavior in carrying out health protocols for the better. This conclusion is obtained from statistical testing which states that from this study (1) the enforcement of discipline by Satpol PP can increase the level of compliance of community behavior in carrying out health protocols in Tegal Regency, (2) there is a change in the state of compliance with community behavior in carrying out health protocols in Kabupaten Tegal. Tegal after the enforcement of discipline by the Tegal Regency Satpol PP.

The Implementation Science of Financial Intelligence in Evidence-Based Medicine Using Select Criteria Mechanism as Treatment Process towards Healthcare Corporate Governance

Purpose: Implementation science is the broader aspect of corporate social responsibility (CSR) translating healthcare education to clinical research and practice for public health and patient safety encompassing the hierarchy of evidence-based medicine (EBM), hence, serving as an integrative method of combing CSR towards healthcare corporate governance. This paper aims to model EBM under principles of valid contract formation as compliance to CSR theories of promoting positive health outcomes of patient safety leading to financial success and lessening the risks of mortality cases.
 Methodology: The elements of valid contract formation and sources of errors are the systematic plan for behavioral guidance of EBM practice. These determinants are crucial in refining the clinical judgment of medical experts together with other healthcare professionals in support with high-ranking databases of research publication, resulting to a greater impact of positive health outcomes of patient safety under “judicious” application of CSR. These principles of contract law are integrated for “measuring” the EBM’s financial success towards healthcare corporate governance.
 Findings: EBM is a scientific approach to handle medical cases and reports towards patient safety under clinical judgment of medical expert and healthcare team in corroboration with reliable sources of databases for medical research and review for reducing death rates in healthcare setting. SELECT Criteria Mechanism elucidated EBM as implementation science integrating CSR for behavioral compliance to healthcare corporate governance. First, the modeling of CSR as method to comply with EBM delineates the elements formed for valid contract formation in producing an “ethical” standard as responsibility for optimal patient safety as bargained promise under acceptance of the clinical team. Second, the illustration of the healthcare corporate governance in EBM practice as theory “measures” the reduction of healthcare expenditures from the exhibited means of diminishing mortality cases. Therefore, implementation science serves as an initiation for remediation process of reducing risks of death cases. 
 Recommendation: Implementation science is very important in EBM practice in treating ways of lessening the probability of mortality cases under “ethical” or “judicious” patient safety guidelines as corporate social responsibility. Hence, it is recommended to develop systems for behavioral guidance in a more organized plan of targeting death reduction cases towards financial intelligence as fulfillment in implementation science.

Non-compliance of the European Court of Human Rights decisions: A machine learning analysis

The paper investigates all (971) non-executed pending leading cases of the European Court of Human Rights (ECtHR) between 2012 and 2020 through Machine Learning (ML) techniques. Drawing on the extant scholarship, our interest on compliance has centred on state level and case level variables. For the identification of important variables, four databases have been used. Each country party to the European Convention on Human Rights (ECHR) received 232 distinct factors for eight years. Since we aim to make a parameter estimation for a high-dimensional data set, Simulated Annealing (SA) is employed as feature selection method. In the state level analysis, Support Vector Regression (SVR) model has been applied yielding the coefficients of the variables, which have been found to be important in spelling out non-compliance with the ECtHR decisions. For the case level analysis, different cluster techniques have been utilized and the countries have been grouped into four different clusters. We have found that the states that have relatively high levels of equality before the law, protection of individual liberties, social class equality with regard to enjoying civil liberties, access to justice and free and autonomous election management arrangements, are less susceptible to non-compliance of the decisions of the ECtHR. For the case level analysis, type of violated rights, the existence of dissent in the decision and dissenting votes of national judges for their appointing states affect the compliance behaviour of the states. In addition, a notable result of the research is that if a national judge casts a dissenting vote against the violation judgment of the ECtHR involving the state that appointed him/her, the judgment is likely not to be executed by the respondent state.

Effects of Engagement Rate and Endorsement Rate on Social Media Endorsement Services on Indonesian Tax Compliance

As a matter of fact, the Indonesian tax compliance level is still low compared to the taxpayer population. Tax compliance is a mandatory requirement that must be met by taxpayers, who have met the subjective and objective tax requirements, including endorsers. Nowadays, endorsement services are becoming a popular job among Generation Z and Alpha, especially in Indonesia. Endorsement service income is influenced by the endorsement rate set by the endorser based on engagement rate on the endorser's social media. This paper aims to examine how engagement rate and endorsement rate on social media platforms contribute to Indonesian tax compliance with the endorser's income as a moderator. The results show that with the endorser's income as a moderator, engagement rate and endorsement rate significantly strengthened their influence on tax compliance. Furthermore, the endorser’s income itself did not significantly influence tax compliance, which means taxpayers' tax compliance behavior is not fixed by the endorser’s income. The possible impact of this study is to assess taxpayers understanding regarding endorsement service, especially endorsers, and to educate endorsers regarding the imposition of endorsement service tax to increase the tax compliance of Indonesians.

Effects of Nurses’ Perceptions of Patient Safety Rules and Procedures on Their Patient Safety Performance: The Mediating Roles of Communication about Errors and Coworker Support

Aim. This study aimed to (a) examine the relationship between staff nurses’ perceptions of patient safety rules and procedures and their patient safety performance and (b) investigate potential mediators of this relationship. Background. Implementation of effective management interventions to improve patient safety requires knowledge of the extent to which nurses’ perceptions of a hospital’s rules and procedures regarding patient safety affect their patient safety performance. Methods. This correlational study involved a secondary analysis of cross-sectional survey data collected from 1,053 staff nurses in South Korea. Structural equation modeling was employed to test the proposed mediation model. Five standardized measures were used to assess key study variables: patient safety compliance, patient safety participation, nurses’ perceptions of patient safety rules and procedures, communication about errors, and coworker support. Cronbach’s alpha values for the scales ranged from 0.82 to 0.90. Results. Nurses’ perceptions regarding the usefulness and effectiveness of rules and procedures about patient safety were positively related to their patient safety performance, measured in terms of safety compliance and participation behaviors. Communication about errors and coworker support showed significant mediating effects on these relationships. Conclusions. The findings indicate that the implementation of effective and useful rules and procedures for improving patient safety would facilitate error communication and coworker support, enhancing nurses’ patient safety performance. Implications for Nursing Management. Hospital administrators and nurse managers should consider how they can foster conditions in which nurses perceive rules and procedures regarding patient safety as useful and effective.

Health Education Audiovisual Berbasis Health Belief Model (HBM) terhadap Perilaku Kepatuhan Pasien Tuberkulosis

The purpose of this study was to determine the effect of audiovisual health education based on the Health Belief Model (HBM) on the compliance behavior of tuberculosis patients in Kendari City. The method used a quantitative research type using a quasy-experiment design, namely the pre-post control group design. Research results show that Analysis of paired t tests, showed significant results on the variables of adherence to medication, fulfillment of nutrition and prevention of transmission (p < α = 0.05). The MANOVA test showed that the most influential variable in the intervention group was prevention of transmission (p<0.005) compared to medication adherence and nutrition fulfillment. The conclusion is audiovisual health education based on the Health Belief Model (HBM) can improve TB patient compliance behavior in taking medication, fulfilling nutrition and preventing transmission of tuberculosis patients in Kendari City. 
 
 Keywords: Education, Fulfillment of Nutrition, Health Belief Model, Taking Medication

The Influence of Justice Perception on Tax Compliance Behavior by the Mediating Influence of Social Support: An Empirical Investigation in Pakistan

Governments modify their financial commitments and levy taxes to fund public services. Every person's tax behavior is unique. Tax compliance is a cooperative relationship between active taxpayers and the government. Additionally, taxpayers hide certain assets to claim deductions and lower their tax liability. Rules often include tax audits and penalties to collect tax amounts. The behavior of tax compliance is the primary objective of the research. Using a quantitative technique, we seek the respondent's view of the fairness of tax legislation. Only 325 practitioners filled out the 400 surveys submitted to bar councils. Pakistan has to improve its tax collecting system, which is why there are a lot of issues with tax collection. Lack of knowledge is a significant problem for individuals about tax collection. Policies and rules adopted by the Pakistan government need to be revised, and there is a need to conduct programs and seminars on tax collection for both government and individuals. The legal system is more effective in recovering tax penalties, whereas procedural justice investigates people's tax compliance. Furthermore, taxpayers hide part of their assets to lower their taxable income and file deductions. To evaluate and quantify tax collecting system fraud, tax auditing is an important area of study. There is a favorable and statistically significant correlation between tax compliance behavior and impression of justice, according to the results. This proves that the null hypothesis is false and that there is a significant connection. The framework of Pakistan's tax system may continue to function and contribute to the country's economy if people work together with the government and do their jobs effectively. The tax justice system provides a more effective means of identifying issues and suggesting solutions.

Factors influencing safety compliance behavior among food delivery riders – an application of safety climate model

The increasing of road traffic accidents is threatening the well-being of road users worldwide and a high number of people died or become disabled. Several studies have shown that risky riding is prevalent among motorcyclists, consisting of traditional and new commercial ones, especially in the middle-income–countries (MICs) and low–income–countries (LICs). Griffin and Neal’s [1] safety climate model was used to point out the link between safety climate and safety knowledge and safety compliance; the effect of safety knowledge on safety compliance is also considered as the result of this research. Structural equation modeling (SEM) was used to analyze these relationships among latent constructs. Data was collected from 433 base-app motorcyclists. The results show that the safety knowledge of motorcyclists plays a mediate role in safety compliance and safety climate. The results are useful for developing measures that aim to reduce risky riding behaviors among food delivery riders.

Analysis of Factors Affecting The Implementation of The Integrity Zone Reviewing From The Gap Analysis of Employee Competency in Surabaya Industrial Research and Standardization Institute

Bureaucratic reforms launched by the government are manifested in the form of regulations or policies that must be implemented by all government agencies under the ministry. One form of this policy is the implementation of the integrity zone and the standardization of human resources as a strategic plan which is realized in the form of a competency gap analysis. This study aims to measure compliance behavior, level of complexity, clarity of organizational goals, and level of employee participation in competency gap analysis and implementation of the integrity zone. This descriptive quantitative research takes employee sampling through saturated sampling technique and data analysis is measured through path analysis. The results of the analysis prove the value of t = 2.166; p=0.034 (p<0.05), which proves that there is an effect of the level of compliance on the competency gap; t value = -0.399; p=0.691 (p>0.05) the effect of the level of program complexity on the competency gap was not proven and the value of t = 12.835; p = 0.000 (p <0.05) proves that there is an effect of the competency gap on the implementation of the integrity zone. Competency gap analysis and employee participation levels are classified as being more capable of contributing to the implementation of the integrity zone at the Surabaya Industrial Research and Standardization Institute.

Effects ofvertical integration onthe healthcare system inChina: a systematic review andmeta-analysis.

Vertical integration is one possible way to improve the performance of a healthcare system; however, its effects are inconsistent, and there is a lack of evidence from undeveloped nations. This study aims to systematically review the evidence regarding effects of vertical integration on healthcare systems in China. We searched PubMed, Embase, Cochrane Library, Web of Science, ProQuest Health & Medicine Collection, China Knowledge Resource Integrated Database and Wanfang databases from April 2009 (initiation of new healthcare reform) to May 2021 for randomized controlled trials (RCTs), controlled before and after (CBA) trials, cohort studies and interrupted time series (ITS) trials. Vertical integration in the included studies must involve both primary health institutions and secondary or tertiary hospitals. After screening 3109 records, we ultimately analysed 47 studies, including 27 CBA trials, 18 RCTs and 2 ITS trials. The narrative synthesis shows that all but three studies indicated that vertical integration improved efficiency (utilization and cost of health services), quality of public health services and medical services, health provider-centred outcomes (knowledge and skill) and patient-centred outcomes (patients' clinical outcomes, behaviour and satisfaction). Despite the heterogeneity of vertical integration interventions across different studies, the meta-analysis reveals that it lowered diastolic blood pressure (mean difference (MD) -8.41, 95% confidence interval (CI) -15.18 to -1.65) and systolic blood pressure (MD-5.83, 95% CI -9.25 to -2.40) among hypertension patients, and it lowered HbA1c levels (MD -1.95, 95% CI -2.69 to -1.21), fasting blood glucose levels (MD -1.02, 95% CI -1.53 to -0.50) and 2-hour postprandial blood glucose levels (MD -1.78, 95% CI -2.67 to -0.89). The treatment compliance behaviour was improved for hypertension participants (risk ratio (RR) 1.08, 95% CI 1.04-1.13) and for diabetes patients (RR 1.32, 95% CI 1.08-1.61). Vertical integration in China can improve efficiency, quality of care, health provider-centred outcomes and patient-centred outcomes, but high-quality original studies are highly needed.

Model-based variable impedance learning control for robotic manipulation

The capability to adapt compliance by varying muscle stiffness is crucial for dexterous manipulation skills in humans. Incorporating compliance in robot motor control is crucial for enabling real-world force interaction tasks with human-like dexterity. In this study, we introduce a novel approach, we call “deep Model Predictive Variable Impedance Controller (MPVIC)” for compliant robotic manipulation, which combines Variable Impedance Control with Model Predictive Control (MPC). The method involves learning a generalized Cartesian impedance model of a robot manipulator through an exploration strategy to maximize information gain. Within the MPC framework, this learned model is utilized to adapt the impedance parameters of a low-level variable impedance controller, thereby achieving the desired compliance behavior for various manipulation tasks without requiring retraining or finetuning. We assess the efficacy of the proposed deep MPVIC approach using a Franka Emika Panda robotic manipulator in simulations and real-world experiments involving diverse manipulation tasks. Comparative evaluations against model-free and model-based reinforcement learning approaches in variable impedance control are conducted, considering aspects such as transferability between tasks and performance. The results demonstrate the effectiveness and potential of the presented approach for advancing robotic manipulation capabilities.

The Influence of the University Laboratory Safety Climate on Students’ Safety Behavior: The Parallel Mediating Effects of Ability and Motivation

Students’ unsafe behavior is the main factor related to accidents in university laboratories. The safety climate is an important factor that affects individual safety behavior on the organizational level. Therefore, to improve the effect of university laboratory safety management, based on the theoretical framework of AMO and the SEM method, the influence of the laboratory safety climate on the safety compliance behavior and safety participation behavior of 500 university students in China was investigated and analyzed. The results show that safety ability and safety motivation play parallel mediating roles, and their synergistic effect promotes the generation of safety behavior: the safety climate in the laboratory has a direct positive effect on both safety compliance behavior and safety participation behavior; safety knowledge and safety skills have significant mediating effects on both safety compliance behavior and safety participation behavior in the laboratory safety climate; external safety motivation has a significant mediating effect on safety compliance behavior and safety participation behavior in the laboratory safety climate; and internal safety motivation does not have a mediating effect on safety compliance behavior and safety participation behavior in the laboratory safety climate. To improve students’ safety behavior performance, measures such as strengthening the construction of the dynamic improvement mechanism of the laboratory safety climate, optimizing the laboratory safety access system, and taking comprehensive measures to ensure the continuous positive influence of the safety climate on students’ safety behavior can be adopted.

Knowledge, Attitude, Behavior Practices and Compliance of Workers Exposed to Respirable Dust in a Zambian Copper Mine.

Work in the copper mining industry is often associated with exposure to respirable dust and respirable crystalline silica. This exposure has the potential to cause silicosis, an incurable occupational respiratory lung disease. This study aimed at establishing the relationship between knowledge, attitudes, work behavioral practices and compliance with safety standards and workers' exposure to respirable dust. A cross-sectional descriptive survey was conducted on 528 mine workers. The Statistical Package for Social Sciences (SPSS) was used for the descriptives. Structural equation modeling (SEM) with latent variables and partial least squares (LVPLS) analysis were employed to determine the relationship among these variables. The results indicated that of the four hypotheses, two were supported, and two were rejected, showing that there is a significant relationship between exposure to respirable dust and work behavioral practices, as well as compliance with safety standards. Knowledge and attitudes toward respirable dust exposure did not significantly influence exposure. According to the results from the survey, positive work behavioral practices as well as compliance with safety standards were significantly associated with exposure to respirable dust. It is recommended that mines should focus on the miners' work behavioral practices and compliance with safety standards.

Validity of the modified-Distraction-Short-Scale and Verbal-Numeric-Anxiety-Fear-Rating-Scale for children in a preoperative setting.

The perioperative period can be stressful for children and families. Minimizing child distress and investigating the quality of anesthetic care is important. There is a paucity of assessment tools available to assess perioperative anxiety in children. To determine the validity and reliability of the modified-Distraction-Short-Scale and the Verbal-Numeric-Anxiety-Fear-Rating-Scale in a perioperative setting for children. Children (n = 189, 3-12 years old) scheduled for ear, nose, and throat surgery had their anxiety rated at induction by a registered nurse anesthetist. Two observers individually evaluated video recordings of the perioperative period. The Verbal-Numeric-Anxiety-Fear-Rating-Scale was used to assess the children's preoperative anxiety and fear, and the modified-Distraction-Short-Scale was used to evaluate coping behavior. The modified-Yale-Preoperative-Anxiety-Scale was used to measure preoperative anxiety and behavioral compliance during anesthesia induction. Interrater reliability showed excellent agreement between observers on modified-Distraction-Short-Scale scores (weighted kappa (Kw ) = 0.91) and Verbal-Numeric-Anxiety-Fear-Rating-Scale (Kw = 0.84). The agreements between the registered nurse anesthetist and observers were moderately good for modified-Distraction-Short-Scale (Kw = 0.65-0.80) and Verbal-Numeric-Anxiety-Fear-Rating-Scale scores (Kw = 0.65-0.75). The intraclass correlation coefficient (ICC) for the registered nurse anesthetist and two observers was excellent for modified-Distraction-Short-Scale scores (ICC = 0.96) and Verbal-Numeric-Anxiety-Fear-Rating-Scale (ICC = 0.90). Regarding concurrent validity, modified-Distraction-Short-Scale and Verbal-Numeric-Anxiety-Fear-Rating-Scale scores were strongly correlated among all three observers (Spearman's correlation coefficient [rs ] = 0.75-0.82). The modified-Yale-Preoperative-Anxiety-Scale scores were moderately correlated with modified-Distraction-Short-Scale (rs = 0.57-0.66) and Verbal-Numeric-Anxiety-Fear-Rating-Scale scores (rs = 0.54-0.67). Construct validity was tested by using age as a discriminating variable, and Verbal-Numeric-Anxiety-Fear-Rating-Scale, modified-Distraction-Short-Scale, and modified-Yale-Preoperative-Anxiety-Scale scores were lower for the older age group; however, only modified-Distraction-Short-Scale (Observer 1: p = .035, Observer 2: p = .022), and modified-Yale-Preoperative-Anxiety-Scale scores were significantly lower (p < .001). The modified-Distraction-Short-Scale and the Verbal-Numeric-Anxiety-Fear-Rating-Scale are simple and valid tools for assessing children's perioperative anxiety or fear and evaluating coping behavior. These results suggest that both scales are useful tools for routine clinical practice and research.