Cognitive Interviews Research Articles

Translation and validation of the international consultation on incontinence questionnaire-Bowel in Danish men and women with pelvic floor disorders.

We lack a comprehensive validated Danish questionnaire to evaluate symptoms and bother regarding anal incontinence (AI). The International Consultation on Incontinence Questionnaire-Bowel (ICIQ-B) is an internationally recommended questionnaire containing 21 items, of which 17 are scored in three subscales: bowel pattern, bowel control, and quality of life. To translate the ICIQ-B into Danish and to validate the Danish version in pelvic floor disorder (PFD) patients with and without AI. The ICIQ-B was translated by a panel of healthcare professionals followed by cognitive interviews with PFD patients attending an outpatient clinic. Revisions were undertaken using an iterative process, and a backward translation was performed for the final version. Pretesting and test-retest of the ICIQ-B were done online and administrated together with the St. Mark's score. Content, structural, convergent and discriminant validity were assessed, followed by an evaluation of relative and absolute reliability, including the smallest real difference (SRD). Thirty cognitive patient interviews were performed, resulting in three revisions. The Danish ICIQ-B was found to be comprehensible and relevant but lacked items addressing the psychological impact of bowel problems. The ICIQ-B was completed online by 227 PFD patients with and without AI. The structural validity of the bowel pattern subscale could not be retrieved. Patients indicating AI had significantly higher ICIQ-B and St. Mark's scores than patients without AI, and ICIQ-B subscale scores correlated moderately with St. Mark's scores. Internal consistency was good except for the bowel pattern subscale. Seventy-six patients completed test-retest. Relative reliability was excellent for subscale scores and moderate or good for single items except for the item concerning stool consistency, which was weak. The SRD was found to be 2.8 for the bowel pattern subscale, 4.3 for bowel control subscale, and 3.6 for the quality-of-life subscale. The Danish version of the ICIQ-B can be used for Danish patients with PFD, and discriminant validity is good. The structural validity and the internal consistency of the bowel pattern subscale are questionable, indicating that some items do not represent the underlying construct. Test-retest reliability of the ICIQ-B is acceptable, but the change needed to reflect a real change above the measurement error in each subscale is three to four points.

Development of a Child-Informed Measure of Subjective Well-Being for Research on Residential Care Institutions and Their Alternatives in Low- and Middle-Income Countries

Abstract10% of children worldwide live in households without a biological parent, and 5.4 million children live in residential care institutions. This study describes a participatory, child-informed process of developing a multidimensional measure of child subjective well-being tailored towards the priorities of children who have lived in residential care. Eight focus groups were held with n = 49 adolescents reunified with family after living in residential care in Kenya and Guatemala and six focus groups were held with n = 29 young adults who had lived in residential care during childhood. After analysis of the focus groups, and using the Orphans and Vulnerable Children Wellbeing Tool as a foundation, the resulting tool contained 43 survey questions. Member checking, translation, and cognitive interviewing were conducted. The survey was administered to N = 180 young people in Kenya and Guatemala who were reunified with family after living in residential care or at risk of entering residential care. Exploratory factor analysis indicated that the measure had three salient factors with good convergent validity and internal consistency: care and safety (12 items), basic needs (13 items), and leisure and freedom (7 items). This study contributes a new, psychometrically validated survey measure that can be used to assess the well-being of children connected to residential care, as well as a replicable model for creating contextualized quantitative measures via child participation that can inform policymaking on children’s care in low- and middle-income countries.

Vision-related quality of life in children: Cross-cultural adaptation and test-retest reliability of the Danish version of the paediatric refractive error profile 2.

To translate and cross-culturally adapt PREP2 into Danish and to investigate the face validity and reliability of Danish PREP2 through cognitive interviewing, Rasch and reliability analyses. The Danish PREP2 was translated using a standardized procedure and then pretested following the Three-Steps-Interviews (TSTI) process. A total of 15 myopic children aged 7-14 wearing either orthokeratology lenses (ortho-k) or single-vision spectacles (SVS) were included in pretesting comprising cognitive interviews and Rasch analysis. Data from cognitive interviewing was analysed thematically according to Collins. Rasch analysis was used to pretest the psychometric properties in terms of person- and item-fit statistics. Reliability was assessed via test-retest using Intra-class correlation coefficient (ICC) in the CONTROL study population, which consisted of 60 Danish children aged 7-14 years wearing either ortho-k or SVS. Fifteen children participated in pilot studies comprising of cognitive interviewing and Rasch analysis and 44 out of 60 CONTROL children participated in test-retest reliability analysis. The translation process resulted in a Danish version of PREP2 corroborating the original. Pretesting highlighted issues in the contextualization of items and in marking responses. Thus, we introduced a digital format with help texts. Cognitive interviewing identified issues in the following Collins' themes: comprehension (understanding of concepts), judgement (ambiguity of items) and response (selecting answers). Rasch analysis indicated that help texts were useful for clarifying context. The ICC was 0.77 (95% CI: 0.66-0.85). The cross-cultural adaptation of PREP2 was satisfactory and issues were identified and corrected through pretesting. The test-retest reliability showed substantial consistency. The instrument could be validated in a more generalizable setting in future studies. NCT03246464 (CONTROL study).

A Mixed Methods Study Evaluating Public Understanding of “Plastic” and “Cosmetic” Surgery

Abstract Goals/Purpose The aesthetic marketplace has expanded significantly over the past decade. There has been a corresponding expansion in the types of providers offering aesthetic procedures and the organizations certifying these providers. These include the American Board of Plastic Surgery (ABPS) and the American Board of Cosmetic Surgery (ABCS). Because patients self-pay for aesthetic procedures, they exercise a high degree of autonomy when choosing a provider. Given the need to support patients in making informed decisions, this study aimed to investigate how the public understands the distinction between “plastic” and “cosmetic” surgery using a mixed methods approach. Methods/Technique The study was completed in two parts: qualitative interviews and a survey. Semi-structured qualitative interviews were conducted with post-operative aesthetic surgery patients. An interview guide asking about participants’ understanding of “plastic” versus “cosmetic” surgery was developed in collaboration with content and methodology experts, then refined through pilot testing. Purposive sampling of patients maximized representation of demographic characteristics and type of surgery. A codebook was constructed using constant comparative grounded theory, which was then applied to interview transcripts to identify emergent themes. Next, a survey instrument investigating the public’s perception of “plastic” versus “cosmetic” surgery and ABPS versus ABCS was formulated from themes identified in the interviews. Pre-testing by cognitive interviews confirmed item validity, and pilot testing confirmed internal consistency. The survey was distributed on Mechanical Turk, with respondents receiving $1.50 as compensation. Results/Complications To achieve thematic saturation, 24 patients were interviewed. Intercoder reliability was high (κ > 0.8). Most (18/24) participants viewed plastic and cosmetic surgery as the same (Table 1). Almost all (23/24) discussed the aesthetic component of plastic surgery while fewer (16/24) participants mentioned the aesthetic component of cosmetic surgery (Table 1). Furthermore, some participants (7/24) misunderstood the scope of cosmetic surgery, including reconstructive procedures under its umbrella (Table 1). 600 respondents completed the survey. When asked how the scopes of plastic and cosmetic surgery relate to each other, a plurality of respondents believed plastic and cosmetic surgery overlap, but each has unique features (35.4%, Figure 1). 25.9% thought plastic and cosmetic surgery were the same, and only 13.9% correctly selected that plastic surgery is inclusive of all cosmetic surgery (Figure 1). When asked who they would go see for various procedures, a plurality of respondents chose a cosmetic surgeon (44.7-49.0% depending on the procedure, Figure 2). A minority stated they would see a plastic surgeon (23.4-29.9% depending on the procedure, Figure 2) or had no preference between a plastic surgeon and a cosmetic surgeon (23.4-28.8% depending on the procedure, Figure 2). However, when asked who they thought was more qualified to perform aesthetic surgery, a plurality of respondents selected an ABPS-certified physician (ABPS 42.2%, ABCS 25.9%, both equally 26.8%, Figure 3). Conclusion These results demonstrate that despite efforts by professional plastic surgery societies, confusion remains about the difference between “plastic” and “cosmetic” surgery, with a portion of the public conflating the two. Furthermore, the survey results indicate that although the public recognizes ABPS certification as a signifier of legitimacy, they may view these physicians as “cosmetic surgeons”. These gaps in public knowledge demonstrate the need for more robust public education campaigns and legislative initiatives to increase transparency and aid patients in making informed choices about their aesthetic providers.

The PELI-D II Study: Development and Preliminary Validation of the Preferences for Leisure Activities Inventory (P-LAI) for Adult Day Services

ABSTRACT Objectives The current study aimed to develop and preliminarily validate an initial version of an instrument to assess the leisure activity preferences of people receiving adult day services (ADS). Methods Based on previously conducted concept mapping steps, we identified 12 clusters of preferences for leisure activities. We adopted the structure of the Preferences for Everyday Living Inventory and phrased our cluster labels as questions to develop a first draft of the Preferences for Leisure Activities Inventory (P-LAI). We conducted cognitive interviews (n = 8) to revise, preliminarily validate, and preliminarily finalize the P-LAI. Results The draft of the P-LAI included 25 questions. Based on the results of the cognitive interviews, the number of questions was reduced to 21, three questions were rephrased, and evidence to support the preliminary validity of the P-LAI based on the response processes was provided. Conclusions The P-LAI is the first instrument to assess preferences for leisure activities in the ADS environment. Clinical implications The preliminary results of the P-LAI allow ADS providers and healthcare professionals to assess the preferences for leisure activities of people who receive ADS in a structured way. Based on these results, preference-based services can be designed and planned, and the person-centered philosophy of care can be further operationalized in the ADS environment.

Acceptability and content validity of suicidality screening items: a qualitative study with perinatal women

BackgroundSuicide is a leading cause of death for perinatal women. It is estimated that up to 50% of women with mental health issues during pregnancy and/or after birth are not identified, despite regular contact with healthcare services. Screening items are one way in which perinatal women needing support could be identified. However, research examining the content validity and acceptability of suicide-related screening items with perinatal women is limited.AimsThis study sought to: (i) assess the acceptability and content validity of 16 suicide-related items that have been administered and/or validated in perinatal populations; and (ii) explore the potential barriers and facilitators that may affect how women respond to these items when administered during pregnancy and after birth.MethodsTwenty-one cognitive and semi-structured interviews were conducted with pregnant and postnatal women in the UK. The sample included women who had experienced self-reported mental health problems and/or suicidality during the perinatal period, and those who had not. Interviews were transcribed verbatim, and a coding framework based on the Theoretical Framework of Acceptability was applied to explore the data using deductive and inductive approaches.ResultsFindings indicated that the acceptability and content validity of suicide-related items were largely unacceptable to perinatal women in their current form. Women found terms such as ‘better off dead’ or ‘killing myself’ uncomfortable. Most women preferred the phrase ‘ending your life’ as this felt less confronting. Comprehensibility was also problematic. Many women did not interpret ‘harming myself’ to include suicidality, nor did they feel that abstract language such as ‘leave this world’ was direct enough in relation to suicide. Stigma, fear, and shame was central to non-disclosure. Response options and recall periods further affected the content validity of items, which created additional barriers for identifying those needing support.ConclusionsExisting suicide-related screening items may not be acceptable to perinatal women. Maternity practitioners and researchers should consider the phrasing, clarity, context, and framing of screening items when discussing suicidality with perinatal women to ensure potential barriers are not being reinforced. The development of specific suicidality screening measures that are acceptable, appropriate, and relevant to perinatal women are warranted.

Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls’ health and education outcomes.

BackgroundMenstrual health is essential for gender equity and the well-being of women and girls. Qualitative research has described the burden of poor menstrual health on health and education; however, these...

Health system implementation of the PROMIS Cognitive Function Screener in the Medicare Annual Wellness Visit: framing as abilities versus concerns

BackgroundCognitive assessment is a required component of the Medicare Annual Wellness Visit (AWV). In this prospective study, we evaluated acceptability and usefulness of a patient-reported outcome measure (the PROMIS® Cognitive Function Screener, or PRO-CS) to screen for cognitive impairment during the AWV. We compared two versions of the PRO-CS: Abilities and Concerns.MethodsWe developed PRO-CS Abilities and PRO-CS Concerns using items from the PROMIS Cognitive Function item banks. We partnered with a large health system in Pennsylvania to implement an electronic health record (EHR)-integrated version of the 4-item PRO-CS into their AWV workflow. PRO-CS Abilities was implemented in June 2022 and then replaced with PRO-CS Concerns in October 2022. We used EHR data to evaluate scores on Abilities versus Concerns and their association with patient characteristics. We gathered feedback from providers on experiences with the PRO-CS and conducted cognitive interviews with patients to evaluate their preferences for Abilities versus Concerns.ResultsBetween June 2022 and January 2023, 3,088 patients completed PRO-CS Abilities and 2,614 patients completed PRO-CS Concerns. Mean T-scores for Abilities (54.8) were slightly higher (indicating better cognition) than for Concerns (52.6). 10% of scores on Abilities and 13% of scores on Concerns indicated concern for cognitive impairment (T-score < 45). Both Abilities and Concerns were associated with clinical characteristics as hypothesized, with lower scores for patients with cognitive impairment diagnoses and those requiring assistance with instrumental activities of daily living. Abilities and Concerns had similar negative correlations with depression (r= -0.31 versus r= -0.33) and anxiety (r= -0.28 for both), while Abilities had a slightly stronger positive correlation with self-rated health (r = 0.34 versus r = 0.28). In interviews, providers commented that the PRO-CS could be useful to facilitate conversations about cognition, though several providers noted potential limitations of patient self-report. Feedback from patients indicated a preference for PRO-CS Concerns.ConclusionsOur findings suggest potential utility of the PRO-CS for cognitive screening in the Medicare AWV. PRO-CS Abilities and Concerns had similar associations with patient clinical characteristics, but the Concerns version was more acceptable to patients.

The efficacy of the Self‐Administered Interview: A systematic review

AbstractObtaining accurate information from eyewitnesses is a crucial element in criminal investigations. Interview strategies such as the Cognitive Interview (CI) and the Self‐Administered Interview (SAI) have been developed and implemented to minimise inaccuracies and enhance the recall and reliability of eyewitness evidence. The SAI is a recent development within forensic psychology. However, a question remains as to the effectiveness of the SAI as an investigative interview tool. A systematic review of published studies employing the SAI was conducted (n = 22), and all were considered in relation to three variables (estimator, system and methodological). As the number of studies within the evidence base was relatively small, we could not ascertain whether the SAI is an effective investigative interviewing tool. However, the results demonstrate a number of positive benefits of the SAI. We discuss the implications of these findings for policy and directions for future research.

Translation, Cultural Adaptation, and Content Validation of a Pleural Mesothelioma Questionnaire to Portuguese Context – A Key Tool for Epidemiological Surveillance

Objective: The main objective of this study was to describe the translation, cultural adaptation, and content validation process of the French National Surveillance Programme for Pleural Mesothelioma (FNSPPM) questionnaire for the Portuguese context. Methods: A search was conducted in the PubMed database and Web of Science, in the period from January 1, 1960, to December 31, 2022, to select the questionnaire. Forward and reverse translations, calculation of the content validity index (CVI) by a panel of experts (n = 9), and cognitive interviewing with individuals with at least one exposure to asbestos (n = 10) were performed. Experts rated items on a Likert scale (1-4) based on their relevance. The item-level content validity index (I-CVI), scale-level content validity index based on the average method (S-CVI/Ave), and scale-level content validity index based on the universal agreement method (S-CVI/UA) were calculated. Results: The final version of the FNSPPM questionnaire for the Portuguese context resulted from a translation and content validation process. The panel of experts considered the questionnaire relevant, with an I-CVI of up to 0.78 in 68 of 69 of the questions, an S-CVI/Ave of 0.98, and an S-CVI/UA of 0.90. The participants in the cognitive interviews reported an understanding of the questionnaire. Conclusion: A validated FNSPPM questionnaire for the Portuguese context is now available to study individuals with pleural mesothelioma (PM) and asbestos exposure.

A new look at parenting through the cultural context: Development and initial psychometric evidence of the Interculturally Sensitive Parenting Scale (ISPAS)

This study aimed to evaluate the measurement characteristics of a newly developed scale to assess interculturally sensitive parenting for mothers and fathers of children and adolescents ranging from 4 to 18 years of age. The development of the Interculturally Sensitive Parenting Scale (ISPAS) ended up with five separate samples, with a total of 1522 parents (884 mothers and 638 fathers), in a five-step process. In the first phase, we generated a pool with 28 items and received input from content experts (n = 5) and cognitive interviews (n = 10), resulting in 23 items. In Study 2 (n = 602), which included inter-item and item-total correlations, eigenvalues, exploratory factor analysis, scree plots, and parallel analysis, six more items were excluded from the item pool, resulting in a one-dimensional construct with 17 items. In Study 3 (n = 607), along with parenting role (mother and father) invariance, confirmatory factor analysis supported the single-factor construct with 17 items, with excellent internal consistency with a high Cronbach's alpha. In Study 4 (n = 303), the analyses indicated that the ISPAS with a one-dimensional construct had good discriminant and convergent validity. Lastly, the 4-week test-retest reliability analysis of the ISPAS in Study 5 (n = 204) supported the stability of the measure. Taken together, the findings validated the usage of the 17-item ISPAS in reliably assessing mothers' and fathers' interculturally sensitive parenting. We hope academics from different disciplines, practitioners, mental health professionals, and educators will benefit from the assessment of the ISPAS presented in this study.

Children’s understanding of well-being related questions: results of cognitive interviews in four European countries

ABSTRACT This paper presents the results of cognitive interviews with 8-year-old children from four European countries – Croatia, France, Finland, and Ireland. The aim of the interviews was to pre-test a selection of well-being-related questions as a part of questionnaire development for the first European multinational birth cohort study – Growing up in Digital Europe (GUIDE)/EuroCohort. Unlike most previous studies, we focused on a younger and more age-homogenous sample, as well as a more diverse set of well-known questionnaires. A total of 68 children participated in the study. The main suggestion for the interviewing procedure is to create a safe environment yet minimize the parents’ interference in answering. The questionnaires should use child-friendly vocabulary, tangible examples, avoid complex sentence structure and negative statements. The use of timeframes in questions should be minimal. The children can use Likert-type scales, but the number of different scales in the questionnaire should be limited.

Cross-cultural adaptation and psychometric validation of point-of-care outcome assessment tools in Chinese palliative care clinical practice

BackgroundA standardized national approach to routinely assessing palliative care patients helps improve patient outcomes. However, a quality improvement program-based on person centered outcomes within palliative care is lacking in Mainland China. The well-established Australian Palliative Care Outcome Collaboration (PCOC) national model improves palliative care quality. This study aimed to culturally adapt and validate three measures that form part of the PCOC program for palliative care clinical practice in China: The PCOC Symptom Assessment Scale (PCOC SAS), Palliative Care Problem Severity Scale (PCPSS), Palliative Care Phase.MethodsA study was conducted on cross-cultural adaptation and validation of PCOC SAS, PCPSS and Palliative Care Phase, involving translation methods, cognitive interviewing, and psychometric testing through paired assessments.ResultsCross-cultural adaptation highlighted the need to strengthen the link between the patient’s care plan and the outcome measures to improve outcomes, and the concept of distress in PCOC SAS. Analysis of 368 paired assessments (n = 135 inpatients, 22 clinicians) demonstrated that the PCOC SAS and PCPSS had good and acceptable coherence (Cronbach’s a = 0.85, 0.75 respectively). Palliative Care Phase detected patients’ urgent needs. PCOC SAS and PCPSS showed fair discriminant and concurrent validity. Inter-rater reliability was fair for Palliative Care Phase (k = 0.31) and PCPSS (k = 0.23–0.30), except for PCPSS-pain, which was moderate (k = 0.53).ConclusionsThe Chinese version of PCOC SAS, PCPSS, and Palliative Care Phase can be used to assess outcomes as part of routine clinical practice in Mainland China. Comprehensive clinical education regarding the assessment tools is necessary to help improve the inter-rater reliability.

Exploring the content validity of the Chalder Fatigue Scale using cognitive interviewing in an ME/CFS population

ABSTRACT Background The Chalder Fatigue Scale, also known as the Chalder Fatigue Questionnaire (CFQ) is a Patient Reported Outcome Measure (PROM) comprising 11 items designed to measure physical and cognitive fatigue. It is widely used with people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). There is no published evaluation of the content validity of the CFQ. Objectives To elicit information regarding the cognitive processes undertaken by people living with ME/CFS, when completing the CFQ to allow examination of the CFQ’s content validity. Methods A qualitative study utilising semi-structured cognitive interviewing. All data were collated according to the CFQ item but some general criticisms of the content validity of the CFQ were also identified. Results The CFQ currently consists of one item clearly related to physical symptoms (1.6), four items clearly related to cognitive function (1.8, 1.9, 1.10, 1.11) and one item relating to fatigue (1.5) which could be interpreted as cognitive and/or physical fatigue. The other five items have been identified by participants as lacking clarity (1.1, 1.7), relating to behaviour not symptoms (1.2, 1.4), or relating to sleepiness not fatigue (1.3). Conclusion Participants provided a wealth of insight into the challenges related to relevance, comprehensiveness, and comprehensibility of the CFQ, indicating that revision is required. This strengthens the case for participation of people with lived experience at all stages of PROM development. There is a need for an assessment tool/PROM for clinical and research use ME/CFS which has undergone content validation involving people living with ME/CFS.

‘I crave not to feel uncomfortable’ – investigating craving for opioids and cannabis among individuals with chronic pain

Background The assessment of drug craving is common in survey studies, including those using real-time data collection methods, such as Ecological Momentary Assessment (EMA). However, few studies investigate how participants with chronic pain interpret the word ‘craving’ and how interpretations impact survey responses. Methods We conducted a mixed-methods study among 12 individuals with chronic pain who were using prescription opioids and cannabis. Participants completed baseline surveys, cognitive interviews, and 14-day smartphone-based EMA data collection. Analyses included deductive and inductive coding of interviews and t-tests of EMA self-reports of opioid and cannabis craving. Results Four participants had negative reactions to the word ‘craving’, including mentions that these questions offended them. The remaining eight participants mentioned no negative connotation. EMA data showed that participants without negative reactions reported a greater range (opioids), higher standard deviation (opioids), and higher maximum (opioids, cannabis) on Likert-type EMA craving items, compared to those with a negative reaction. Conclusions Some individuals with chronic pain may have a negative reaction to the word ‘craving’ related to opioid and cannabis use and this reaction may impact survey responses. Alternative wording of survey items is recommended, for example focused on ‘wanting’ or ‘needing’.

Swedish translation and psychometric testing of the Self-Conscious Emotions in COPD Questionnaire

Assessment of self-conscious emotions is important to develop tailored interventions for people with chronic obstructive pulmonary disease (COPD). Previous instruments have largely been developed for mental health populations. The Self-Conscious Emotions in COPD Questionnaire was the first instrument to assess self-conscious emotions in people with COPD, but it was only available in English.The aim was to translate the Self-Conscious Emotions in COPD Questionnaire into Swedish and to evaluate its psychometric properties and internal structure in a Swedish context.The translation process included forward and backward translation, a multidisciplinary meeting, assessment of content validity, and cognitive interviews. The translated instrument was tested in a sample of 173 people with COPD between September 2021 and September 2022. Parallel analysis (PA), exploratory factor analysis (EFA), and test-retest reliability was performed.The content validity index (CVI) for the instrument was 0.88. Based on the PA, an EFA with a two-factor solution was conducted, with a high Cronbach's alpha (0.786–0.821), and one item about self-blame was excluded. The two factors were labelled: The burden of living with a disability and The desire to hide vulnerability. Test-retest reliability showed no difference between scale scores on factor or item level, except for one item.The Swedish Self-Conscious Emotions in COPD showed good validity and reliability. One item was excluded from the two subscales, indicating that the instrument needs to be further developed to cover the concept of self-blame. The instrument is expected to be a valuable tool for assessing self-conscious emotions in people with COPD.

Argentine version of the PediEAT, a pediatric eating assessment tool.

Introduction. During childhood, children may experience some degree of difficulty eating. A tool (PediEAT) has been developed in the United States and is available to assess pediatric eating and to identify problematic symptoms. Objective. To obtain an Argentine version that is transculturally adapted, culturally adequate, and semantically equivalent to the original version. Population and methods. A self-administered version of the PediEAT was used and completed by families and/or caregivers of children aged 6 months to 7 years. In the first phase, content validity was assessed by a group of experts. This was followed by a pre-test phase with families using cognitive interviews to test word and phrase comprehension. The necessary changes were made to obtain a version adapted to the context. Results. The tool's content validity was assessed by a group of 8 experts; as a result, 36 of the 80 items were changed. During the pre-test phase, cognitive interviews were conducted with 18 caregivers; 11 items were changed to improve comprehension by the Argentine population. The Argentine version was approved by the original authors. Conclusions. The Argentine version of the PediEAT tool is linguistically equivalent to the original version, and this allows its use to screen for feeding problems in children.

Development and validation of the patient-reported outcome for older people living with HIV/AIDS in China (PROHIV-OLD)

BackgroundThe involvement of quality of life as the UNAIDS fourth 90 target to monitor the global HIV response highlighted the development of patient-reported outcome (PRO) measures to help address the holistic needs of people living with HIV/AIDS (PLWHA) beyond viral suppression. This study developed and tested preliminary measurement properties of a new patient-reported outcome (PROHIV-OLD) measure designed specifically to capture influences of HIV on patients aged 50 and older in China.MethodsNinety-three older people living with HIV/AIDS (PLWHA) were interviewed to solicit items and two rounds of patient cognitive interviews were conducted to modify the content and wording of the initial items. A validation study was then conducted to refine the initial instrument and evaluate measurement properties. Patients were recruited between February 2021 and November 2021, and followed six months later after the first investigation. Classical test theory (CTT) and item response theory (IRT) were used to select items using the baseline data. The follow-up data were used to evaluate the measurement properties of the final instrument.ResultsA total of 600 patients were recruited at the baseline. Of the 485 patients who completed the follow-up investigation, 483 were included in the validation sample. The final scale of PROHIV-OLD contained 25 items describing five dimensions (physical symptoms, mental status, illness perception, family relationship, and treatment). All the PROHIV-OLD dimensions had satisfactory reliability with Cronbach’s alpha coefficient, McDonald’s ω, and composite reliability of each dimension being all higher than 0.85. Most dimensions met the test-retest reliability standard except for the physical symptoms dimension (ICC = 0.64). Confirmatory factor analysis supported the structural validity of the final scale, and the model fit index satisfied the criterion. The correlations between dimensions of PROHIV-OLD and MOS-HIV met hypotheses in general. Significant differences on scores of the PROHIV-OLD were found between demographic and clinical subgroups, supporting known-groups validity.ConclusionsThe PROHIV-OLD was found to have good feasibility, reliability and validity for evaluating health outcome of Chinese older PLWHA. Other measurement properties such as responsiveness and interpretability will be further examined.

A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study.

The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice. A mixed methods cognitive task analysis with a convergent triangulation design. Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions. The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic. The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist. Patients and public were not involved in this research.

Examining Student Perception on Mobile Augmented Reality Integration, Gender Differences, Learning Styles, Feedback, Challenges, and Opportunities in an Online Physics Class

This study aimed to investigate the perception of STEM students (n = 147) on using mobile Augmented Reality (AR) across gender and learning styles in physics online classes. It utilized embedded mixed-method research and purposive sampling. An instrument named Students Perception in Integrating Mobile AR in Physics Class was developed and has undergone a series of validations such as item generation from literature review, content validation, cognitive interview, pilot testing, and exploratory factor analysis revealing two factors, CFA with indices that are of acceptable value, and good Cronbach alpha (α = 0.86) for reliability. Mean, standard deviation, percentages, two samples t-test, and thematic analysis were used to analyze the data. Results revealed that all students have a source of internet connection as well as a device to use and most of them have a very stable to somewhat stable internet connection. Positive feedback was shown in terms of overall learning experience and perception across gender and learning styles. However, in terms of overall usability, females have more ease of use compared to males and kinesthetic learners only have a positive response. It was also found that there is no significant difference across gender. Moreover, the integration of AR in a physics lesson has received excellent responses from both students with and without prior experience in a classroom setting. All of the difficulties the students encountered were technological in nature. There are also opportunities to improve the integration of mobile AR in the technical and learning process. These results suggest that teachers should integrate mobile AR in online physics classes but should consider factors such as Internet connection, device, gender, and learning styles in developing the application.