Comparative Fit Index Values Research Articles

Online Health Information Seeking, eHealth Literacy, and Health Behaviors Among Chinese Internet Users: Cross-Sectional Survey Study.

The internet has become an increasingly vital platform for health-related information, especially in upper-middle-income countries such as China. While previous research has suggested that online health information seeking (OHIS) can significantly impact individuals' engagement in health behaviors, most research focused on patient-centered health communication. This study aims to examine how OHIS influences health behavior engagement among Chinese internet users, focusing on the role of eHealth literacy and perceived information quality in influencing relationships. An online cross-sectional survey was conducted in November 2021 among 10,000 Chinese internet users, using quota sampling based on sex, age, and urban and rural residence, in line with the 48th Statistical Report on Internet Development of China. Nonparametric tests were used to examine the differences in eHealth literacy across sociodemographic groups. Partial correlation analysis and stepwise linear regression were conducted to test the associations between key variables. Confirmatory factor analysis and structural equation modeling were conducted to test the hypotheses. Our study identified significant disparities in functional and critical eHealth literacy between urban and rural residents across age groups, income levels, education backgrounds, and health conditions (all P<.001). In terms of sex and regional differences, we found higher functional literacy among female users than male users, and critical literacy varied significantly across different regions. The proposed structural model showed excellent fit (χ2404=4183.6, χ2404=10.4,P<.001; root mean square error of approximation value of 0.031, 95% CI 0.030-.031; standardized root mean square residual value of 0.029; and comparative fit index value of 0.955), highlighting reciprocal associations between 2 types of eHealth literacy and OHIS. Participants' functional eHealth literacy, critical eHealth literacy, and OHIS have positive impacts on their health behavioral engagement. Perceived information quality was found to mediate the influence of OHIS on health behavior (b=0.003, 95% CI 0.002-0.003; P<.001). The study revealed the pathways linking sociodemographic factors, eHealth literacy, OHIS, and perceived information quality and how they together influenced health outcomes. The findings underscore the significance of enhancing eHealth literacy and improving information quality to promote better health outcomes among Chinese internet users.

Deriving the PedsUtil health state classification system to measure health utilities for pediatric populations based on the PedsQL: a confirmatory factor analysis.

An important methodological challenge in conducting pediatric economic evaluations is estimating the preference-based health-related quality of life (HRQoL) of children. Current methods are highly variable and there is no single instrument available to value HRQoL consistently across multiple pediatric age groups. The Pediatric Quality of Life Inventory (PedsQL) is a non-preference-based generic HRQoL instrument validated for children 2-18 years, but it cannot be directly used in economic evaluations. The aim of this study was to establish the core dimension structure of the PedsUtil health state classification system using confirmatory factor analysis, which is the first step of deriving a preference-based measure of HRQoL based on the PedsQL. Four competing dimension structures of the PedsUtil health state classification system were developed based on published literature and expert opinion. Using data from the Longitudinal Study of Australian Children (LSAC) (n = 45,207), the 4 dimension structures were evaluated using the robust weighted least squares estimation method. The analyses were stratified by 2-year age intervals (from 2 to 17 years) to reflect the study design of the LSAC, as well as special healthcare needs status of the child. Model fit was evaluated by examining standardized factor loadings and various fit indices including the comparative fit index (CFI), Tucker-Lewis Index (TLI), and the root mean square error of approximation (RMSEA). Modification indices and residual correlations were examined to re-specify the models to improve model fit when necessary. The findings supported a 7-dimension structure (i.e., Physical Functioning, Pain, Fatigue, Emotional Functioning, Social Functioning, School Functioning, and School Absence) of the PedsUtil health state classification system. The 7-dimension model exhibited adequate fit across subgroups with CFI values that ranged from 0.929 to 0.954, TLI values from 0.916 to 0.946, and RMSEA values from 0.058 to 0.102. This study established the core dimension structure of the PedsUtil health state classification system using confirmatory factor analysis. The 7-dimension structure was found to be applicable across diverse pediatric populations. Research is currently ongoing to select the most representative item within each dimension of the PedsUtil health state classification system and valuation surveys will be fielded to estimate the PedsUtil scoring system.

Developing an Emotional Labor Scale for Employees in the Service Industry

Purpose: This research aims to develop an emotional labor scale and examine the consistency of the emotional labor measurement model with empirical data. The study focuses on individuals with long-term work experience and incorporates cross-cultural perspectives to address gaps in current research. Additionally, it seeks to create a standardized model for measuring and evaluating emotional labor that is applicable to contemporary work environments. Methodology: The population is front-service employees of hotels in Chonburi Province, and the sample consists of 280 front-service employees of hotels in Pattaya City, Chonburi Province. The research methodology for developing the emotional labor scale in this phase is quantitative research, using confirmatory factor analysis to examine the consistency of the emotional labor measurement model. Findings: The results of the model fit analysis and quality assessment of the CFA model found that the RMSEA (Root Mean Square Error of Approximation) was 0.217, indicating a lack of fit between the model and data. The CFI (Comparative Fit Index) was 0.591. The TLI (Tucker-Lewis Index) was 0.442. Finally, the IFI (Incremental Fit Index) was 0.595. Based on the presented indices, this model has a poor fit with the data. The RMSEA, CFI, TLI, and IFI values are lower than the recommended criteria, indicating a discrepancy between the model and data. Unique Contribution to Theory, Policy and Practice: These findings suggest that current emotional labor measurement models may not accurately capture the experiences of workers across different cultures and with varying lengths of work experience. Policymakers and organizations should consider developing more nuanced and culturally sensitive approaches to assess and manage emotional labor in the workplace. This could involve creating tailored training programs, revising performance evaluation metrics, and implementing supportive policies that acknowledge the complexity of emotional labor across diverse work environments.

Coronavirus-related health literacy level of Turkish adults: psychometric properties of the scale.

An adequate level of health literacy enables people to adopt protective behaviors to cope with the COVID-19 pandemic. Validated instruments are desired to assess such reactions. This study aims to determine the level of health literacy and validity and reliability of the Coronavirus-Related Health Literacy Questionnaire (HLS-COVID-Q22) adapted to Turkish. The present study was carried out with 452 participants in Turkey using an online survey. The scale was translated from English to Turkish using the back-translation technique. The cultural adaptation was outlined in the context of establishing the validity and reliability of the instruments. A coronavirus-related health literacy measure was validated (HLS-COVID-Q22) for the Turkish population through exploratory factorial analysis, followed by a confirmatory factorial analysis. The coronavirus-related health literacy level of the participants was found to be 2.92 (± 0.51). Cronbach's alpha internal consistency coefficient was found to be 0.95. A four-factor solution was confirmed with eigenvalues > 1.0, suggesting a four-factor solution and explaining 68.84% of the total variance. It was determined that the χ2/df and root mean square residual, root mean square error of approximation and comparative fit index values in the last model had a good fit and that the normed fit index, goodness-of-fit index and adjusted goodness-of-fit index values were acceptable. The coronavirus-related health literacy level of Turkish adults was moderate. HLS-COVID-Q22 was a reliable and valid instrument for measuring coronavirus-related health literacy in the Turkish population. Promoting population-based health literacy and making decisions on accurate and reliable information are important in coping with the epidemic.

Adaptation and validation of the west haven-yale multidimensional pain inventory for Pakistani population.

To evaluate the adapted version of West Haven-Yale Multidimensional Pain Inventory for patients with chronic pain. The multiphase study was conducted from January to December 2021. The factorial structure of the Urdu version of West Haven-Yale Multidimensional Pain Inventory was evaluated on a sample of adult patients aged 18- 45 years with non-specific chronic pain, taken from public and private hospitals and clinics of Lahore, Pakistan. The Urdu version was then subjected to factor analysis, while Cronbach's alpha, composite reliability, convergent and discriminant validity of the scale were also calculated. Data was analysed using SPSS 24. Of the 306 subjects, 204(66.7%) were females and 102(33.3%) were men. The overall mean age was 30.94+/-8.44 years. There were 166(54.2%) subjects who were married, and 137(44.8%) reported experiencing pain daily. The confirmatory factor analysis showed a 45-item structure for 12 sub-scales as the best fit. The statistics for the final model were observed as minimum discrepancy function by degrees of freedom divided was 1.69, root mean square error of approximation was 0.05, and standardised root mean square residual was 0.06. Comparative fit index value was 0.91 and Tucker-Lewis coefficient was 0.90. Cronbach's alpha reliability ranged between 0.68 and 0.89 for the subscales, while for the total scale, it was 0.72. The Urdu version of West Haven-Yale Multidimensional Pain Inventory was found to be a reliable and valid tool for chronic pain assessment for patients in Pakistan.

Purchases Decision Making Inventory: Measurement Validation in Indonesia

The empirical limitations of the Consumer Styles Inventory (CSI) render the formation of dimensions from this measuring tool-less relevant. Scholars have attempted developing Purchase Decision Making Inventory (PDMI) measuring tool to answer cognitive and emotional processes in decision-making. This research examined the validity of the internal structure of the purchasing decision-making inventory (PDMI) measuring device in the Indonesian context. PDMI has two main dimensions, namely emotional and reasoned. The emotional dimension has five sub-dimensions: impulsivity, indebtedness, negative emotions, frustration, and hedonism. The reasoned dimension has three sub-dimensions: saving, reasoning, and information seeking. The main dimensions explain the differences in cognitive and affective processes that occur in consumers when making decisions. The internal structure of PDMI was evaluated using Confirmatory Factor Analysis (CFA) and reliability analysis. The population of this study was Indonesian people aged 18-25 years (M = 20.3 years, SD = 1.55). The sample in this study was 588. The results of the CFA analysis showed that the results fit the data. The model accuracy indices used are the comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA). The CFI value is 0.932, the TLI value is 0.921, and the RMSEA is 0.046. The results of this research are supported by the reliability results of each sub-dimension and the primary dimension of the PDMI measuring instrument, which has a Cronbach's alpha value ≥ 0.6 with a corrected item-total correlation (CITC) ≥ 0.3 which can be concluded that the PDMI measuring device is valid based on internal structure and reliable evidence sources.

CULTURAL ADAPTATION AND PSYCHOMETRIC VALIDATION OF THE SELF EFFICIENCY AND PERFORMANCE IN SELF-MANAGEMENT SUPPORT (SEPSS) QUESTIONNAIRE IN UNDERGRADUATE NURSING AND MEDICAL STUDENTS OF BANGLADESH

In an aging society, healthcare professionals and students face increasing demands to actively involve patients in the decision-making process regarding their health conditions and lifestyles. Self-management support is considered a best practice that aligns with the patient-centered care paradigm in Bangladesh. However, there is currently no instrument available to assess healthcare professionals’ competencies in this field, particularly during their early education and training period. The aim of this study was to translate the Self Efficiency and Performance in Self-management Support (SEPSS) instrument into Bangla and validate its psychometric properties in a sample of undergraduate healthcare students in Bangladeshi higher education institutions. A cross-sectional study was conducted to assess the reliability, validity, and cultural appropriateness of the Bangla version of SEPSS-36 among 486 nursing and medical students. Confirmatory factor analysis was carried out using the chi-square model fit index (CMIN), comparative fit index (CFI), and Root Mean Square Error of Approximation (RMSEA) as fit indices. The internal consistency was estimated by the Cronbach alpha coefficient. The results indicate that the CMIN (2.658) and RMSEA (.058) values suggest that the sample data and hypothetical model are an acceptable fit in the analysis, with satisfactory CFI values (.895). The reliability for all SEPSS dimensions was acceptable. The Bangla version of the SEPSS questionnaire is a valid and reliable instrument that can assist healthcare educators and researchers in determining students’ competencies within this domain.

Development of a Scale to Measure Children's Educational Mobile Application Usage for Foreign Language

The widespread use of mobile applications in education has led to the need for reliable and valid measurement tools to assess their impact on language learning, particularly among young learners. This study investigated the developmental process and psychometric properties of the Children's Educational Mobile Application Usage for Foreign Languages Scale. The item pool was created by examining the studies obtained from the literature review. To evaluate the appearance and content validity of the scale, the expert assessment of the scale, which the researcher developed, was applied to 19 experts. Consequently, the experts' opinions were considered to update the Children's Educational Mobile Application Usage for Foreign Languages Scale. Pilot studies were conducted with 37 students in the 4th grade. Data were collected from 309 4th-grade students to conduct reliability and validity studies. Confirmatory Factor Analysis was used to determine the scale's construct validity. The Chi-square/degrees of freedom ratio is 2.54, and the Comparative Fit Index value is calculated as .954. The Confirmatory Factor Analysis confirmed the theoretical structure consisting of 16 items with three factors, and the compliance indices showed perfect compliance. Cronbach Alpha (α) coefficient was used to determine the scale's reliability. The Cronbach Alpha value is calculated as 0.945. As a result, the Children's Educational Mobile Application Usage for Foreign Languages Scale was valid and reliable. The study highlights the novelty of the scale, being one of the first psychometric scales in the literature explicitly targeting children's educational mobile application usage for foreign language learning. It can aid institutions in developing or updating mobile applications and investigating the relationship between children's educational mobile application use and other variables. While this study presents a valuable contribution to the field, it also acknowledges limitations, such as the sample size and reliance on personal statements for data collection. Nonetheless, Children’s Educational Mobile Application Usage for Foreign Languages opens new avenues for research and has the potential to enhance language education by harnessing innovative technology-driven approaches.

Measurement Model of Technopreneurship Intentions and the Performance of Electrical Lighting Installation Practices in Vocational High School

The aims of this study are to produce measurement model of the intention of technopreneurship and the performance of the practice of electric lighting installations. Analysis of the data used is confirmatory factor analysis. Confirmatory Factor Analysis has several stages to determine the results. These stages include determining goodness of fit, calculating path estimation, calculating loading factor, Average Variance Extracted (AVE), and calculating reliability using Construct Reliability (CR). Goodness of fit is determined by looking for the Goodness-of-Fit Index (GFI), Norm Fit Index (NFI), Comparative Fit Index (CFI), or Root-Mean-Square Error of Approximation (RMSEA). CFI, RMSEA, loading factor, and tcount values met the suitability index criteria. These results indicate that the model for measuring technopreneurship intention variables and the performance of electrical lighting installation practices theoretically matches the field data, so that the measurement model is acceptable.

Psychometric testing of a Danish version of the empowerment of parents in the intensive care - Neonatology questionnaire has confirmed validity.

Investigating parent satisfaction with care is important to guide quality development. In this study, we translated and validated a Danish version of the empowerment of parents in the intensive care - neonatology (EMPATHIC-N) questionnaire to determine validity in Danish contexts. A psychometric study design was applied. Translation was performed according to recommended international standards. Confirmatory factor analyses including standardised factor loadings, Cronbach's α reliability estimates, congruent validity and non-differential validity testing were applied. The study was performed from June 2017 to November 2019 at a 33-bed level IV neonatal intensive care unit. Participants were 311 parents (response rate=42,8%). Confirmative factor analyses disclosed a moderate model fit of the instrument with Comparative Fit Index (CFI) values of 0.83-0.92. Cronbach's α showed good reliability (0.82-0.93). Congruent validity showed good positive correlations (0.48-0.71) between the instrument domains and four overall satisfaction indicators. In search of improved model fit, a version including 27 items was tested. This version showed a better model fit with CFI values of 0.92-0.99 and satisfactory Cronbach's α values. Model fit for the Danish full EMPATIC-N was moderate. The shorter version showed better psychometric properties.

Establishing and validating a survey for trauma-informed, culturally responsive change across multiple systems

AimThe purpose of the present study was to establish and validate the Survey for Trauma-Informed Systems Change (STISC), a measure of culturally responsive trauma-informed care (TIC) and services that can be administered to professionals in any field or industry.Subject/methodsThe current study with 262 respondents from judicial, healthcare, political, non-profit, and for-profit settings examined the internal consistency reliability and factor structure of the STISC.ResultsA total of 262 respondents from various industries accessed the pre-training survey. Seven of the 59 items were reassigned to alternate subscales and three subscales were merged following correlation analysis. Internal consistency reliability for subscales based on the final item assignments was good or excellent (lower 95% confidence limits for hierarchical omega ≥ 0.85). The root mean square error of approximation estimate for the confirmatory factor analysis based on final item assignments was acceptable (0.073; 90% CI 0.071, 0.076). Neither the comparative fit index value of 0.76 nor the Tucker–Lewis fit index value of 0.75 approached conventional thresholds for acceptable fit.ConclusionGiven the absence of a validated alternative, this study supports use of the STISC tool to measure the degree of an individual’s trauma-informed knowledge and positive attitudes toward trauma-informed systems change, as well as trauma-informed practices in the workplace. Further study and refinement will aim to determine whether the STISC survey is sensitive to change, which will provide stronger support for the survey’s potential usefulness as a cost-effective method of standardizing trauma-informed systems change programs across multiple fields and industries.

Phubbing among Lebanese young adults: Scale validation and association with mental health (depression, anxiety, and stress).

Mobile phones use has not been without several social and psychological problems, specifically during the fast spread of the COVID-19 infection, which imposed strict restrictions and isolation. This research principal aims were to (1) confirm the validity of the Generic Scale of Phubbing in Arabic (GSP), and (2) evaluate the association between phubbing and mental health (depression, anxiety and stress). A first cross-sectional study enrolled 203 participants to confirm the factor structure of the phubbing scale among Lebanese young adults. A confirmatory factor analysis (CFA) was carried out on the whole sample using SPSS AMOS v.24 to confirm the four-factor structure of the GSP. The root mean square error of approximation (RMSEA) statistic, the comparative fit index (CFI) and the Tucker Lewis Index (TLI) were used to evaluate the goodness-of-fit of the model. RMSEA values ≤0.08 and ≤ 0.10 indicate a good and acceptable fit respectively. CFI and TLI values ≥0.90 indicate good model fit. A second cross-sectional study enrolled 461 respondents (18-29 years old) to conduct the multivariable analysis. The fit indices values were as follows: χ2/df = 181.74/84 = 2.16, TLI = .92, CFI = .94 and RMSEA = .076 [95% CI .061-.091] respectively, indicating an excellent fit of the model. The results of the multiple linear regression using the ENTER model, when taking the phubbing score as the dependent variable, showed that female gender (β = 0.11; t(454) = 2.50; p = .013), more stress (β = 0.27; t(454) = 3.94; p < .001), more anxiety (β = 0.30; t(454) = 4.24; p < .001), and older age (β = 0.28; t(454) = 6.12; p < .001) were positively correlated with higher phubbing, or higher household crowding index (β = −0.15; t(454) = −3.62; p < .001) was significantly correlated with less phubbing. The results of this study were able to confirm the validity of the Arabic version of the GSP scale. This will allow Lebanese clinicians to use this validated tool to screen for the presence of the phubbing phenomenon within this age group. We propose finding possible correlation between phubbing and others factors (such as obsession and loneliness) and validating this scale in other Arabic-speaking countries.

Turkish Validity-Reliability Study of the Celiac Disease-Specific Pediatric Quality of Life Scale.

Celiac disease is an autoimmune enteropathy triggered by the presence of gluten. There are Celiac Disease Dutch-Child Quality of Life Scale, Celiac-Specific Pediatric Quality of Life Scale for children/adolescents patients to measure the quality of life. In this study, due to lack of quality of life scales for children with celiac in Turkey, we aimed at Turkish adaptation of the Celiac-Specific Pediatric Quality of Life Scale. This methodological study was conducted in Ankara University Faculty of Medicine, Cebeci Hospital Hospital between July 2019 and July 2020. A total of 192 children were included. Reliability was demonstrated by the Cronbach's alpha coefficient. Structural validity was evaluated using explanatory factor analysis and confirmatory factor analysis. The Statistical Package for Social Sciences (SPSS) 22.0 and Amos were used in analyses. In 8-12 age groups; Cronbach's alpha was 0.92 in negative emotions dimension, 0.88 in school dimension, and 0.74 in enjoyment dimension. In explanatory factor analysis, Kaiser-Meyer-Olkin measure of sampling adequacy value was 0.698, Bartlett's test of sphericity was significant (P < .001). Variance explained was 75.8%. In confirmatory factor analysis, X2/df was 3.26, root mean square error of approximation value was 0.07, comparative fit index value was 0.96. In 13-18 age groups; Cronbach's alpha was 0.87 in social dimension, 0.84 in uncertainty dimension, 0.78 in isolation dimension, and 0.83 in limitations dimension. In explanatory factor analysis, Kaiser-Meyer-Olkin measure of sampling adequacy was 0.684, Bartlett's test of sphericity was significant (P < .001). Variance explained was 68.6%. In confirmatory factor analysis, X2/sd value was 3.78, root mean square error of approximation value was 0.061, and comparative fit index value was 0.961. Cronbach's alpha values of the groups were found to be above 0.70. Kaiser-Meyer-Olkin values were above 0.5 in terms of sample size, Bartlett's tests for sphericity were significant in terms of correlations between variables, root mean square error of approximation values were below 0.08, comparative fit index and goodness of fit index values were above 0.95 in terms of model fit. If the scales have been found to be valid and reliable, it is recommended for use in Turkey.

Reliability and Validity of the Turkish Version of Impact of Weight on Quality of Life for Kids

Objective:The Impact of Weight on Quality of Life—Kids is a self-reported weight-related quality of life measure that has been validated for children and adolescents aged between 11 and 19. Impact of Weight on Quality of Life—Kids does not have a Turkish version. The aim of this study was to explore the reliability and validity of the Impact of Weight on Quality of Life—Kids in Turkish.Materials and Methods:The Impact of Weight on Quality of Life—Kids was translated into Turkish using Mapi Research Institute's suggested international translation technique. The psychometric evaluation included test–retest reliability, internal consistency, discriminant validity, concurrent validity, exploratory factor analysis, and confirmatory factor analysis.Results:For the total score, the internal consistency of the scale (Cronbach's alpha coefficient) was 0.93. The item-total score correlation coefficients ranged from 0.178 to 0.785. The test-retest coefficients were found to be 0.94 for the total score and the subscales ranged from 0.66 to 0.89 after 2 weeks. Discriminant validity analysis demonstrated that the instrument differentiated well between the obese and non-obese samples. Five variables were discovered via factor analysis that explained 66.9% of the total variation. The chi-square/degree of freedom ratio value was 3.535, the comparative fit index value was 0.834, and the value of root mean square error of approximation was 0.10, as determined by confirmatory factor analysis.Conclusion:Our results demonstrated the adequate reliability and validity of the Impact of Weight on Quality of Life—Kids, suggesting that this scale is a useful tool for screening Turkish children and adolescents for weight-related quality of life.

Reliability and Validity of the Turkish Version of Impact of Weight on Quality of Life for Kids.

The Impact of Weight on Quality of Life-Kids is a self-reported weight-related quality of life measure that has been validated for children and adolescents aged between 11 and 19. Impact of Weight on Quality of Life-Kids does not have a Turkish version. The aim of this study was to explore the reliability and validity of the Impact of Weight on Quality of Life-Kids in Turkish. The Impact of Weight on Quality of Life-Kids was translated into Turkish using Mapi Research Institute's suggested international translation technique. The psychometric evaluation included test-retest reliability, internal consistency, discriminant validity, concurrent validity, exploratory factor analysis, and confirmatory factor analysis. For the total score, the internal consistency of the scale (Cronbach's alpha coefficient) was 0.93. The item-total score correlation coefficients ranged from 0.178 to 0.785. The testretest coefficients were found to be 0.94 for the total score and the subscales ranged from 0.66 to 0.89 after 2 weeks. Discriminant validity analysis demonstrated that the instrument differentiated well between the obese and non-obese samples. Five variables were discovered via factor analysis that explained 66.9% of the total variation. The chi-square/degree of freedom ratio value was 3.535, the comparative fit index value was 0.834, and the value of root mean square error of approximation was 0.10, as determined by confirmatory factor analysis. Our results demonstrated the adequate reliability and validity of the Impact of Weight on Quality of Life-Kids, suggesting that this scale is a useful tool for screening Turkish children and adolescents for weight-related quality of life.

Validity of the Personal Impact of Epilepsy Scale (PIES) in patients with epilepsy in Uganda

PurposeWe sought to address the construct validity and reliability of the Personal Impact of Epilepsy Scale (PIES), an epilepsy-specific quality-of-life measure, in patients with epilepsy in Uganda. We also sought to assess the applicability of the scale across three languages: English, Luganda, and Runyankole. MethodsPatients with epilepsy (N = 626) were recruited at the time of care seeking from Mulago National Referral Hospital (MNRH), Butabika National Referral Mental Hospital (BNRMH), and Mbarara Regional Referral Hospital (MRRH), and were given the English, Runyankole, and Luganda versions of the PIES as a part of a larger interview. Reliability, internal consistency specifically, was assessed using three parameters: Cronbach's alpha, McDonald's Omega, and composite reliability. Construct validity (internal structure) was evaluated with principal component analysis (PCA) for three factors, as well as confirmatory factor analysis (CFA) for a three-factor structure of the scale. We also assessed correlations between the three PIES subscales and the seizure severity question in the Liverpool Seizure Severity Scale (LSSS) and reported seizure frequency. ResultsThe three-factor model of the PIES had adequate reliability, with Cronbach's Alpha, McDonald's Omega, and composite reliability values over 0.7, except for the Cronbach's Alpha and McDonald's Omega values for the second factor, which was slightly lower than 0.7 in the full sample as well as when stratified by study language. The PCA and CFA models for the scale demonstrated adequate fit with the Tucker–Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA), with TLI and CFI values above 0.9 and RMSEA values less than 0.08. However, the model demonstrated inadequate fit with the Chi-square indicator, which yielded a significant p-value. Individual factor loadings ranged from 0.50 to 0.95 in the full sample, 0.45 to 0.98 in the English sample, and 0.45 to 0.93 in the Luganda sample. Finally, the three PIES subscales aligned with reported seizure frequency and the seizure severity question from the LSSS. ConclusionsThis study presents the first Luganda and Runyankole versions of the PIES, and the first validation of this scale in English and Luganda with patients with epilepsy in Uganda. The PIES was found to have acceptable psychometric properties for reliability and validity parameters. Thus, the scale is recommended for use and for further investigation in patients with epilepsy in Uganda.This article is part of the Special Issue “The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda”

Factor Analysis and Clustering of the Movement Disorder Society-Non-Motor Rating Scale.

The primary validation of the Movement Disorder Society Non-Motor Rating Scale was recently published, but 2 important structural analyses were not included. The objective of this study was to examine the structural characteristics of the Movement Disorder Society Non-Motor Rating Scale by factor and cluster analyses. Data came from the validation study, an international multicenter cross-sectional study of 402 Parkinson's disease patients. Demographic and clinical data, the Movement Disorder Society Non-Motor Rating Scale, and Hoehn and Yahr staging were used. Exploratory and confirmatory factor analysis and nonhierarchical cluster analysis were performed. The exploratory factor analysis showed that all 13 domains of the Movement Disorder Society Non-Motor Rating Scale, except 1, and the Non-Motor Fluctuations subscale performed as unidimensional (variance explained: 0.36, sleep and wakefulness; -0.82, orthostatic hypotension). The confirmatory factor analysis could be carried out in 9 domains and showed that 6 of them and the Non-Motor Fluctuations subscale adjusted to the model satisfactorily according to the root mean square error of approximation. Furthermore, all domains had comparative fit index values >0.95, except depression and pain (both, 0.94) and sleep and wakefulness (0.90). The Non-Motor Fluctuations subscale showed satisfactory root mean square error of approximation (0.07), but a low comparative fit index value (0.91). A 5-cluster solution, correctly classifying 96% of the cases, was found. Overall, most subscales of the Movement Disorder Society Non-Motor Rating Scale are unidimensional, and although each subscale is distinct in terms of content covered, factors and clusters that are of clinical relevance are discernible and contribute to our understanding of possible nonmotor subtypes in Parkinson's disease. © 2020 International Parkinson and Movement Disorder Society.

Structural validation of the ORTO-12-FR questionnaire among a French sample as a first attempt to assess orthorexia nervosa in France.

To the best of our knowledge, no scientific publications on orthorexia nervosa have been based on a French population. The goal of our study was to confirm the factor structure of the French version of the ORTO-15 questionnaire. An online survey (N = 768) was conducted asking participants (84.77% were women) to answer several questions about their dietary habits and to assess orthorexia nervosa using the ORTO-15 scale. Confirmatory factor analysis (CFA) was used for the validation. Given our results, we deemed it necessary to adapt the French version of the ORTO-15 questionnaire by omitting three items. The CFA supported the ORTO-12-FR (composed of 12 items and addressing three domains: rational, emotional, and behavioral) as the better-fitting model, with an internal consistency of 0.73. The Comparative Fit Index value was 0.93, the Tucker-Lewis Index was 0.90, and the Root Mean-Square Error of Approximation was 0.05. Our results provide evidence for the reliability of ORTO-12-FR with a French population. V, descriptive cross-sectional study.

PCN423 MEASURING FATIGUE SYMPTOMS AND IMPACTS IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): EVALUATING DIMENSIONALITY OF THE FACIT-FATIGUE

The Functional Assessment of Cancer Therapy–Fatigue (FACIT-Fatigue) is a well-validated instrument to assess fatigue in cancer or other chronic illnesses. It can be reported as a single global fatigue score (GFS) or as separate scores for symptoms (FSS) and impacts (FIS) (Cella, 2011). Confirmatory factor analysis (CFA) and bifactor analysis were conducted to evaluate if this dimensionality also holds in the CLL population. FACIT-Fatigue data from 263 CLL patients were analyzed. Single factor models were specified for GFS, FSS and FIS to determine the dimensionality of all 13 items of FACIT-Fatigue. A bifactor model was tested including a global factor (defined by loadings of all 13 items) and two subdomain factors: symptoms (5 items) and impacts (8 items). Criteria of a Root Mean Square Error of Approximation (RMSEA) <0.10 and a Comparative Fit Index (CFI) >0.90 were set to define acceptable model fit. Mean scores for the items ranged from 0.53 to 2.23 (item range 0-4). For the three single-factor models specified (GFS, FSS and FIS), CFI values were >0.90 and RMSEA <0.10. All item factor loadings were statistically significant and >0.3. Bifactor model fit was excellent (CFI>0.95; RMSEA<0.08). All items had higher loadings on GFS, ranging from 0.36 (“Able to do my usual activities”) to 0.92 (“Trouble starting things”), than on their sub-domain factors, supporting the essential unidimensionality of the FACIT-Fatigue. Conclusion: Results confirmed the findings of Cella (2011) in the CLL population. FACIT-Fatigue is unidimensional, and the GFS is a valid endpoint to report in clinical research. If preferred by researchers, it can also be supplemented with two definable components of fatigue, symptoms and impacts, as supported by the bifactor model and CFA results for each subdomain. Being able to distinguish between these components enhances understanding of patients’ experience in CLL.

EBP Implementation Leadership of Frontline Nurse Managers: Validation of the Implementation Leadership Scale in Acute Care.

Frontline nurse managers influence the implementation of evidence-based practices (EBP); however, there is a need for valid and reliable instruments to measure their leadership behaviors for EBP implementation in acute care settings. The aim of this study was to evaluate the validity and reliability of the Implementation Leadership Scale (ILS) in acute care settings using two unique nurse samples. This study is a secondary analysis of ILS data obtained through two distinct multisite cross-sectional studies. Sample 1 included 200 registered nurses from one large Californian health system. Sample 2 was 284 registered nurses from seven Midwest and Northeast U.S. hospitals. Two separate studies by different research teams collected responses using written and electronic questionnaires. We analyzed each sample independently. Descriptive statistics described individual item, total, and subscale scores. We analyzed validity using confirmatory factor analysis and within-unit agreement (awg). We evaluated factorial invariance using multigroup confirmatory factor analyses and evaluating change in chi-square and comparative fit index values. We evaluated reliability using Cronbach's alpha. Confirmatory factor analyses in both samples provided strong support for first- and second-order factor structure of the ILS. The factor structure did not differ between the two samples. Across both samples, internal consistency reliability was strong (Cronbach's alpha: 0.91-0.98), as was within-unit agreement (awg: 0.70-0.80). Frontline manager implementation leadership is a critical contextual factor influencing EBP implementation. This study provides strong evidence supporting the validity and reliability of the ILS to measure implementation leadership behaviors of nursing frontline managers in acute care. The ILS can help clinicians, researchers, and leaders in nursing contexts assess frontline manager implementation leadership, deliver interventions to target areas needing improvement, and improve implementation of EBP.