Confirmatory Research Articles

The Development and Validation of the Beliefs about Baby Crying at Night (BBCN) Scale

ObjectiveWhat are young children trying to express when they cry at night? According to Sadeh, parental beliefs about why their child is crying may play a role in the development and persistence of their child’s insomnia. The aim of this study was to create a scale that specifically assesses these parental interpretations in different dimensions. MethodsChildren aged between 6 months and 3 years with either good sleep habits or behavioural insomnia were recruited. An initial, 20-item scale for the beliefs of why one’s baby is crying at night was developed, with all items on a 7-point Likert span. The results of this scale from a large sample were then submitted to Exploratory (EFA) and confirmatory (CFA) factor analyses to converge on a final version and evaluate its psychometric properties and validity. ResultsAmong the 1009 subjects included in the analyses (46.2% female, mean age : 1.63 ± 0.73, good sleepers n = 425 and bad sleepers n = 584). After the factor analysis was performed, a 14-item scale with 4 subscales quantifying each interpretation type resulted: namely, “Need for attachment” (5 items), “Need to cry before falling asleep” (3 items), “Leaving a child to cry during the night is traumatizing for the child” (4 items) and “Is in pain” (2 items). The CFA further confirmed an appropriate fit. The most divergent subscale between groups was the “Need for attachment” subscale. ConclusionThis study proposes the first scale known to focus exclusively on parent interpretations of their child’s night-time crying, without taking into account their nursing behaviours. It provides a clinical tool for more effectively discussing with parents, in order to address potential dysfunctional beliefs in the context of early childhood insomnia complaints, as well as a research tool for considering cognitive dimensions in the aetiology and treatment of behavioural insomnia.

The Internal Structure of the WISC-V in Chile: Exploratory and Confirmatory Factor Analyses of the 15 Subtests

The WISC-V is a widely used scale in clinical and educational settings in Chile. Given that its use guides critical decision-making for children and adolescents, it is essential to have evidence of its psychometric properties, including validity based on internal structure. This study analyzed the factor structure of the WISC-V through an exploratory (EFA) and confirmatory (CFA) approach considering the age range of 853 children and adolescents between 6 and 16 years. We obtained evidence favoring the four-factor structure in the EFA, which is a clearer organization in the 15–16 age group. In the confirmatory stage, the best four- and five-factor models showed factor loadings greater than 0.4, except for one subtest in the processing speed domain in the 6–8 age group. The internal consistency ranged from acceptable to good estimates for the best two models. The results support the use of hierarchical factor structures of four and five factors, which offer specific advantages and disadvantages discussed in the article. The implications of these findings in both the professional area of psychology and future research are discussed.

Cultural translation of the ethical dimension: a study on the reliability and validity of the Chinese nurses’ professional ethical dilemma scale

BackgroundQuantifying the professional ethical challenges that nurses encounter is crucial for both theoretical insights and practical outcomes. The objective of this research is to assess the psychometric properties of the Chinese adaptation of the Moral Distress Scale for Healthcare Professionals (MD-APPS).MethodsIn 2024, a survey approach was utilized to engage with several tertiary-level healthcare institutions throughout China. A cohort of 448 nursing professionals who satisfied the specified selection benchmarks was consequently incorporated into the study. To evaluate the scale's reliability and validity, methods including the Content Validity Index (CVI), Factor Analysis—both Exploratory (EFA) and Confirmatory (CFA)—alongside assessments of internal consistency and test-retest reliability were employed.ResultsExpert evaluations yielded an I-CVI of 0.90, suggesting good content validity for the MD-APPS's Chinese adaptation. Exploratory Factor Analysis (EFA) revealed a bi-dimensional framework with 7 components, explaining 56.34% of the cumulative variance. Confirmatory Factor Analysis (CFA) outcomes displayed a χ-square/df ratio of 1.542. The estimate for Robust RMSEA was 0.054, and the SRMR was ascertained to be 0.041. Indices for both Robust TLI and Robust CFI surpassed the 0.9 threshold, indicating an acceptable fit; this aspect was supported by a P-value (Chi-square) of 0.094. The internal consistency, measured by Cronbach's α, was found to be 0.74, while the test-retest reliability over a two-week period reached 0.964. These findings provide initial evidence for the psychometric properties of the Chinese MD-APPS.ConclusionThe Chinese adaptation of the MD-APPS demonstrates promising initial psychometric properties, suggesting its potential suitability for exploring nurses' professional ethical challenges within the Chinese cultural context. This scale may facilitate the identification of diverse elements influencing nurses' professional ethics and the assessment of the ethical climate in nursing practices. However, further validation studies are needed to fully establish its psychometric robustness across various healthcare settings in China.

Validation of factor structures of the Drinking Motives Questionnaire among the Czech young and adult general population

BackgroundAlcohol use is one of the leading public health concerns in the Czech Republic. Drinking motives play a vital role in both initiation and subsequent alcohol use. A revised version of the self-report Drinking Motives Questionnaire (DMQ-R) has been proposed to assess these motives. The present study aims to validate the DMQ-R in the Czech general population.MethodsA total sample of 1,784 Czech participants completed a national survey. For the analysis, only a sub-sample of the past 12 months alcohol users was used: N = 1,123; 52.8% male; mean (SD) age = 40.2 (13.3). Drinking motives were assessed by the adopted Czech version of the DMQ-R. Both confirmatory (CFA) and exploratory factor analysis (EFA) were conducted to examine the factorial structure of the instrument. The age of the participant was additionally considered in the analysis (15–24 years as opposed to 25–64 years).ResultsThe CFA supported the four-factor model in the 25–64 age group. The analysis supported the construct validity of the Social, Conformity, and Coping factors. The Enhancement factor retained only two items and was found to refer more to a domain of ‘Pleasant Feeling’. For the 15–24 age group, the hypothesised four-factor structure was not corroborated.ConclusionsThe Czech version of the DMQ-R was found to be a reliable measurement tool of the Social, Conformity, and Coping motives. Future research should investigate the dimensionality of the instrument items presumed to correspond to the Enhancement motives. This should be conducted particularly among adolescents and young adults aged 15–24 years, where administering the DMQ-R with a large enough sample is also needed.

Italian Version of the Hospital Aggressive Behaviour Scale-Users: Initial Psychometric Evaluation among Hospital Healthcare Professionals.

Healthcare professionals frequently encounter various forms of aggression, ranging from verbal abuse to physical assaults, which can compromise both their occupational well-being and patient-care quality. Despite its prevalence and serious consequences, workplace aggression is often underreported due to a lack of standardized assessment tools. This study aims to develop a valid Italian version of the Hospital Aggressive Behaviour Scale-Users. The scale's structure was evaluated using exploratory (EFA) and confirmatory (CFA) factor analyses on two samples of healthcare professionals during and after the pandemic. Reliability, measurement invariance, and nomological validity were examined. EFA revealed a two-factor structure comprising eight items (χ2 = 59.651, df = 13, p = 0.00; CFI = 0.98; TLI = 0.95; RMSEA = 0.07; SRMR = 0.02), distinguishing non-physical and physical aggression, and meeting all recommended criteria. CFA confirmed this structure, demonstrating good reliability and outperforming alternative models. The same factor structure was confirmed in standard (χ2 = 35.01, df = 19, p = 0.00; CFI = 0.99; TLI = 0.99; RMSEA = 0.03; SRMR = 0.02) and emergency (χ2 = 30.65, df = 19, p = 0.04; CFI = 0.98; TLI = 0.97; RMSEA = 0.06; SRMR = 0.04) contexts. Full residual invariance was found across job tenure groups. Aggression was positively associated with emotional exhaustion, psychological distance, psychosomatic symptoms, post-traumatic stress symptoms, and turnover intentions while negatively related to job satisfaction. Nurses and healthcare assistants reported higher levels of aggression than doctors. This study provides a reliable, context-specific instrument for documenting and analysing outsider aggression. The insights can inform targeted interventions, contributing to a healthier hospital environment.

Psychometric properties of the Arabic version of PHEEM applied on a sample of medical residents in Syria

BackgroundThe clinical learning environment (CLE) plays a crucial role in shaping the learning experiences and professional development of medical professionals. Understanding and optimising this environment is essential for improving doctors’ knowledge acquisition, clinical skills, and overall well-being. The development of the Postgraduate Hospital Educational Environment Measure (PHEEM) and its translation to numerous languages has been a milestone in clinical education. Even though PHEEM was recently translated into Arabic, its psychometric properties in this form remain unevaluated. Therefore, this study aims to conduct a comprehensive psychometric analysis of the Arabic version of the PHEEM questionnaire.MethodsThis is a cross-sectional questionnaire survey validation study. The defined population were medical residents in Damascus, Syria. A paper-based survey as well as an online-based one were conducted using several non-probability sampling methods namely, convenience, river and, snowball sampling between June 15, 2023, and June 21, 2023. Both exploratory (EFA) and confirmatory (CFA) factor analyses were conducted. Several psychometric criteria were applied including scree plot, eigenvalue > 1.5 and the ‘proportion of variance accounted for’ criterion.ResultsA total of 543 participants completed the questionnaire (56.9% female). Kaiser-Meyer-Olkin measure for sample adequacy was high (0.937) and the P-value for Bartlett’s test was < 0.001. EFA revealed five meaningful factors which were labelled: perception of teachers, learner’s engagement and social participation, external regulation, work culture, and living conditions. These factors had the following eigenvalues: 12.6, 2.18, 2.03, 1.86, and 1.41 respectively, with a total explained variance of 43.45%. Cronbach’s Alpha was 0.938. CFA confirmed the model structure of EFA (SRMR = 0.067 and RMSEA = 0.066). The Average Variance Explained (AVE) value of any given factor was > 0.7.DiscussionThe Arabic PHEEM inventory demonstrated satisfactory psychometric properties. The extracted domains are of theoretical relevance to the psychosocial-material conceptual framework for learning environment. Nonetheless, this validation was performed in the Syrian context; therefore, future studies in other Arabic countries are recommended to support the applicability of Arabic PHEEM in the wide Arab World.

Children of parents with a mental illness - stigma questionnaire: validation and revision.

Mental disorders are often stigmatized in society. The stigma of mental illness affects people with a mental illness themselves as well as their family members-a phenomenon called stigma by association (SBA). Children of parents with a mental illness (COPMI) are a particular vulnerable group for SBA. In our systematic review, experienced SBA, anticipated SBA, affiliate SBA, and structural discrimination were identified as relevant stigma dimensions for children of parents with a mental illness. To assess SBA in adolescents who grow up with a parent with a mental illness, the COPMI-SQ was developed. N = 930 adolescents completed the study. Of those, N = 380 adolescents (sample 1; 72.6% female, mean age 17.12 (SD = 2.01) years) reported growing up with at least one parent with a mental illness. Using confirmatory (CFA) and exploratory factor analyses (EFA) as well as standard item and reliability analyses, we analyzed and revised the COPMI-SQ in the first sample. To validate the factorial structure of the revised COPMI-SQ, CFA was also conducted in the independent sample of the other N = 550 adolescents (sample 2; 80.0% female, mean age 16.36 (SD = 1.98) years) who reported not growing up with a parent with a mental illness. To test four measurement invariance, a multiple-group CFA was conducted in the combined sample of adolescents who reported growing up with and without a parent with a mental illness (sample 1 and sample 2). CFA in sample 1 resulted in an inadequate model fit for the theoretically assumed four-factor structure (CFI = .687; RMSEA = .064 (90% CI = .062-.066); SRMR = .092; AIC = 229 155.63). Following EFA and item and reliability analyses in sample 1, the COPMI-SQ was reduced to four scales ("Experienced SBA," "Affiliate SBA," "Shame," and "Anticipated SBA") and two additional screening scales ("Healthcare" and "Social support"). To facilitate questionnaire use, only the three best items were retained in each scale, reducing the total item number to 12 plus five additional screener items. CFA in sample 2 also resulted in an inadequate model fit for the theoretically assumed four factor structure (CFI = .667; RMSEA = .065 (90% CI = .063-.066); SRMR = .101; AIC = 335 651.99). In comparison, the final version of the COPMI-SQ-r showed the best model fit (CFI = .945; RMSEA = .062 (90% CI = .052-.072); SRMR = .049; AIC = 60 008.05). In the multiple-group CFA (sample 1 and sample 2), metric invariance was established (χ2 (208) = 481.58, p < .001; CFI = .939; RMSEA = .053 (90% CI = .047-.059); SRMR = .056). In sample 2, internal consistency was found to be good for the total scale (α = .84) and almost acceptable to almost good for the subscales (α = .64 to.78). The revised version of the COPMI-SQ (COPMI-SQ-r) is a reliable and economic questionnaire to assess SBA in adolescents who grow up with a parent with a mental illness. The COPMI-SQ-r can be used to help develop and evaluate anti-stigma and general interventions for affected adolescents.

Design and Psychometric Properties of the Student Perception of Teacher Care Scale in University Students

Teacher care in the university setting is crucial for the academic, emotional, and social development of students, encompassing moral virtues such as compassion and professional competence. The students’ perception of teacher care directly relates to their well-being and active participation in learning. Despite the recognized importance of teacher care, there is a lack of adequate instruments to measure it, especially in specific cultural and educational contexts like Peru. The aim of this research is to develop and assess the psychometric properties of a scale measuring student perception of teacher care in the Peruvian university context, to provide a valid and reliable tool for future research and educational practices. An instrumental study was conducted with 910 university students aged between 18 and 50 years (M = 20.2, SD = 3.45). The Student Perception of Teacher Care Scale (SPTCS) was used, divided into five dimensions (Compassion, Competence, Confidentiality, Trust, and Awareness). Exploratory (EFA) and confirmatory (CFA) factor analyses were conducted to evaluate the scale’s internal structure, along with reliability analyses and measurement invariance across genders. The EFA identified a four-factor structure reflecting the dimensions of Confidentiality and Trust, Competence, Awareness, and Compassion. The CFA confirmed this structure with good fit indices for four-factor models, which was then adjusted to a five-factor model, one of which is a second-order factor (χ2 = 720.727, df = 369, CFI = 0.951, TLI = 0.946, RMSEA = 0.046, and SRMR = 0.032). Internal reliability was high (α and ω &gt; 0.9 for all factors). Measurement invariance was established across genders, allowing for valid comparisons between men and women. It is concluded that the Student Perception of Teacher Care Scale proves to be a valid and reliable instrument for measuring teacher care in the Peruvian university context. The results emphasize the multidimensionality of teacher care and its significance for the educational environment and student experience. This study contributes to educational research and teaching practice, offering a means to assess and improve caring relationships in higher education.

Development and validation of the mindful eating scale (mind-eat scale) in a general population

BackgroundMindful eating is a concept that is increasingly being used to promote healthy eating. Observational studies have suggested associations with healthier eating behaviors, lower weight status, and favorable cardiovascular biomarkers. However, existing scales assessing mindful eating have some limitations. Our study aimed to develop and validate a scale assessing the level of mindful eating in a general population. MethodsThe Mind-Eat Scale was developed in four main steps: 1. Generating an initial item pool covering all aspects of mindful eating; 2. Reviewing items with experts and naive individuals; 3. Administering the scale to a large and representative sample from the NutriNet-Santé cohort (N = 3102); 4. Conducting psychometric analyses. Construct validity was assessed using exploratory (EFA) (N1 = 1302) and confirmatory (CFA) (N2 = 1302, N3 = 498) factor analyses. Content, discriminant, convergent, and divergent validity, internal consistency, and test-retest reliability were examined. ResultsThe initial pool of 95 items was refined to 24 items using EFA. The EFA highlighted six dimensions: Awareness, Non-reactivity, Openness, Gratitude, Non-judgement, and Hunger/Satiety, consisting of four items per dimension. CFAs showed a good fit for first and second-order models. Adequate content validity was confirmed. Discriminant, convergent, and divergent validity were supported by significant differences between subgroups of individuals, and correlations with eating behaviors and psychological well-being scales. The Mind-Eat Scale showed good reliability for all six dimensions, with high McDonald's ω and adequate intraclass correlation coefficients (ICC). ConclusionsThis study validated the first tool assessing a total mindful eating score and its sub-dimensions in a general population. This scale can be an asset for clinical and epidemiological research on dietary behavior and related chronic diseases.

Psychometric Evaluation of the Persian Version of the Post-Traumatic Symptom Scale: Exploratory and Confirmatory Factor Analysis

Background: Iranian youth encounter numerous stressors, including accidents, suicide, and unemployment, heightening their risk for posttraumatic stress disorder (PTSD). It's crucial to assess, diagnose, and treat PTSD in this demographic. Objectives: This study aimed to evaluate the factor structure and validate the Post-Traumatic Symptom Scale (PTSS). Methods: A cross-sectional approach was employed for the validation of the PTSS in Bandar Abbas, 2022, with a sample of 901 young residents selected via random cluster sampling. Data were gathered using the PTSS and the Mississippi Scale for Posttraumatic Stress Disorder (MSPSS). Validation of the scale encompassed content validity, concurrent validity, and factor analysis. Reliability assessments included internal consistency, test-retest, and split-half reliability. The optimal cut-off point was identified through receiver operating characteristic (ROC) curve analysis and the Youden Index. Results: The PTSS demonstrated robust face and content validity, evidenced by impact factor (1.6 &lt; impact factor &lt; 3.6), content validity ratio (CVR = 0.68 to 0.91), and Content Validity Index (CVI = 0.70 to 0.94). The PTSS's concurrent validity with the MSPSS was positively strong (r = 0.64, P &lt; 0.001). Factor analyses, both exploratory (EFA) and confirmatory (CFA), substantiated a four-factor model of the PTSS, accounting for 56.288% of the variance (19% for arousal and reactivity, 14% for negative alterations in cognitions and mood, 11% for avoidance, and 11% for intrusion). The scale's overall Cronbach's alpha was 0.87, with subscales ranging from 0.77 to 0.88. Test-retest reliability stood at 0.81 (P &lt; 0.01), and split-half reliability at 0.81. The PTSS's optimal cut-off for PTSD diagnosis was 60, delivering a sensitivity of 0.70, specificity of 0.99, and Youden Index of 0.69. Conclusions: The PTSS proves to be a reliable and valid instrument for assessing posttraumatic stress symptoms among young Iranians, offering a useful resource for researchers and practitioners in the prevention and treatment of PTSD.

Developing a shortened spine functional index (SFI-10) for patients with sub-acute/chronic spinal disorders: a cross-sectional study

BackgroundBrief whole-spine patient-reported outcome measures (PROMs) provide regional solutions and future directions for quantifying functional status, evidence, and effective interventions. The whole-spine regional Spine Functional Index (SFI-25) is used internationally in clinical and scientific contexts to assess general sub-acute/chronic spine populations. However, to improve structural validity and practicality a shortened version is recommended. This study developed a shortened-SFI from the determined optimal number of item questions that: correlated with criteria PROMs being highly with whole-spine, moderately with regional-spine, condition-specific and patient-specific, and moderately-low with general-health and pain; retained one-dimensional structural validity and high internal consistency; and improved practicality to reduce administrative burden.MethodsA cross-sectional study (n = 505, age = 18-87 yrs., average = 40.3 ± 10.1 yrs) of sub-acute/chronic spine physiotherapy outpatients from an international sample of convenience. Three shortened versions of the original SFI-25 were developed using 1) qualitative ‘content-retention’ methodology, 2) quantitative ‘factorial’ methodology, and 3) quantitative ‘Rasch’ methodology, with a fourth ‘random’ version produced as a comparative control. The clinimetric properties were established for structural validity with exploratory (EFA) and confirmatory (CFA) factorial analysis, and Rasch analysis. Criterion validity used the: whole-spine SFI-25 and Functional Rating Index (FRI); regional-spine Neck Disability Index (NDI), Oswestry Disability Index (ODI), and Roland Morris Questionnaire (RMQ), condition-specific Whiplash Disability Questionnaire (WDQ); and patient-specific functional scale (PSFS); and determined floor/ceiling effect. A post-hoc pooled international sub-acute/chronic spine sample (n = 1433, age = 18-91 yrs., average = 42.0 ± 15.7 yrs) clarified the findings and employed the general-health EuroQuol-Index (EQ-5D), and 11-point Pain Numerical Rating Scale (P-NRS) criteria.ResultsA 10-item SFI retained structural validity with optimal practicality requiring no computational aid. The SFI-10 concept-retention-version demonstrated preferred criterion validity with whole-spine criteria (SFI-25 = 0.967, FRI = 0.810) and exceeded cut-off minimums with regional-spine, condition-specific, and patient-specific measures. An unequivocal one-dimensional structure was determined. Internal consistency was satisfactory (α = 0.80) with no floor/ceiling effect. Post-hoc analysis of the international sample confirmed these findings.ConclusionThe SFI-10 qualitative concept-retention version was preferred to quantitative factorial and Rasch versions, demonstrated structural and criterion validity, and preferred correlation with criteria measures. Further longitudinal research is required for reliability, error, and responsiveness, plus an examination of the practical characteristics of readability and administrative burden.

Psychometric properties of the Kidney Disease Quality of Life short form 36 (KDQOL-36) scale for the assessment of quality of life in Colombian patients with chronic kidney disease on dialysis

PurposeConsidering the importance of incorporating quality of life (QoL) construct during the health care of patients with stage 5 chronic kidney disease (CKD) on dialysis, it is necessary to have evidence on the clinimetric properties of the instruments used for its measurement. This study aimed to establish the clinimetric properties of the Kidney Disease Quality of Life Short Form 36 (KDQOL-36) scale in patients with stage 5 CKD on dialysis in Colombia.MethodsA scale validation study was conducted using the classical test theory methodology. The statistical analysis included exploratory factor analysis (EFA) and confirmatory (CFA) techniques performed on two independent subsamples; concurrent criterion validity assessments; internal consistency using four different coefficients; test–retest reliability; and sensitivity to change using mixed model for repeated measures.ResultsThe KDQOL-36 scale was applied to 506 patients with a diagnosis of stage 5 CKD on dialysis, attended in five renal units in Colombia. The EFA endorsed the three-factor structure of the scale, and the CFA showed an adequate fit of both the original and empirical models. Spearman's correlation coefficient values ≥0.50 were found between the domains of the CKD-specific core of the KDQOL-36 scale and the KDQ. Cronbach's alpha, McDonald's omega, Greatest lower bound (GLB), and Guttman's lambda coefficients were ≥0.89, indicating a high degree of consistency. A high level of concordance correlation was found between the two moments of application of the instrument, with values for Lin's concordance correlation coefficient ≥0.7. The application of the instrument after experiencing an event that could modify the quality of life showed statistically significant differences in the scores obtained.ConclusionThe KDQOL-36 scale is an adequate instrument for measuring QoL in Colombian patients with stage 5 CKD on dialysis.

Sexual function index adaptation for breast cancer patients (FSFI-BC)- translation and psychometric properties of Persian version

BackgroundEffective interventions to improve sexual dysfunction in breast cancer survivors need screening of these dysfunctions with a suitable instrument. The aim of present study was translation and identifying psychometric properties of Female Sexual Function Index – Adapted for Breast Cancer (FSFI-BC) which has been specifically developed for breast cancer survivors.MethodThis methodological study was performed between February 2017 and October 2018. 200 breast cancer survivors in stage 1 or 2 who were selected through convenience sampling method, completed the questionnaire. Reliability was assessed by Cronbach’s alfa and test re-test analysis and construct validity was performed through confirmatory (CFA) and exploratory factor analysis( EFA).ResultsSix factors were extracted in exploratory factor analysis (EFA). These factors explained 74.6% of the total variance in in NSA group and 0.821 in SA group. Reliability evaluation indicated high internal consistency and good test re-test reliability. Cronbach’s alpha coefficient in all areas of the tool was above 0.7 (the lowest and the highest measures were 0.885 and 0.945, respectively), which is a good indicator for reliability of an instrument. Confirmatory factor analysis showed an acceptable fitness for seven factors of FSFI-BC questionnaire (Normed Fit Index or NFI = 0.9 for both groups, Comparative of Fit Index or CFI = 0.93 and 0.92, χ 2/df = 1.68 and 1.71 for SA(Sexually Active) and NSA(No Sexually Active) individuals, respectively) .ConclusionStudy findings suggest that Persian version of FSFI-BC is a suitable instrument for sexual dysfunction screening in breast cancer survivors.

Validation of Educational Quality as a Tool to Measure the Degree of Satisfaction of University Students

The aim of this research was the creation and validation of a questionnaire to assess education quality in university contexts and to find factors that can help improve the educational system. The questionnaire was validated via a psychometric study through exploratory (EFA) and confirmatory (CFA) data analyses from a sample of 1302 subjects to find students’ level of satisfaction in the university environment. The results show good reliability and validity, highlighting three factors: access level to computer aspects; different material resources and university students’ degree of satisfaction with the educational community. We concluded that this validated questionnaire provides information regarding students’ opinions about the quality of education in university contexts and can serve as a measurement tool for the educational system’s good functioning in an effective and efficient way.

A Simple Two-Step Procedure for Fitting Fully Unrestricted Exploratory Factor Analytic Solutions with Correlated Residuals

A frequent criticism of exploratory factor analysis (EFA) is that it does not allow correlated residuals to be modelled, while they can be routinely specified in the confirmatory (CFA) model. In this article, we propose an EFA approach in which both the common factor solution and the residual matrix are unrestricted (i.e., the correlated residuals need not be specified a priori). The estimation procedures are two-stage and based on the unweighted least squares principle. Procedures for judging the solution appropriateness (including goodness of fit) are also proposed. The simulation studies and illustrative example suggest that the approach works quite well Although the proposal is based on existing results, most of the developments can be considered to be new contributions, and are expected to be particularly useful in the earlier stages of item calibration. The whole procedure has been implemented in both R language and a well-known non-commercial EFA program.

Perception of cognitive change by individuals with Parkinson's disease or essential tremor seeking deep brain stimulation: Utility of the cognitive change index.

The Cognitive Change Index (CCI-20) is a validated questionnaire that assesses subjective cognitive complaints (SCCs) across memory, language, and executive domains. We aimed to: (a) examine the internal consistency and construct validity of the CCI-20 in patients with movement disorders and (b) learn how the CCI-20 corresponds to objective neuropsychological and mood performance in individuals with Parkinson's disease (PD) or essential tremor (ET) seeking deep brain stimulation (DBS). 216 participants (N = 149 PD; N = 67 ET) underwent neuropsychological evaluation and received the CCI-20. The proposed domains of the CCI-20 were examined via confirmatory (CFA) and exploratory (EFA) factor analyses. Hierarchical regressions were used to assess the relationship among subjective cognitive complaints, neuropsychological performance and mood symptoms. PD and ET groups were similar across neuropsychological, mood, and CCI-20 scores and were combined into one group who was well educated (m = 15.01 ± 2.92), in their mid-60's (m = 67.72 ± 9.33), predominantly male (63%), and non-Hispanic White (93.6%). Previously proposed 3-domain CCI-20 model failed to achieve adequate fit. Subsequent EFA revealed two CCI-20 factors: memory and non-memory (p < 0.001; CFI = 0.924). Regressions indicated apathy and depressive symptoms were associated with greater memory and total cognitive complaints, while poor executive function and anxiety were associated with more non-memory complaints. Two distinct dimensions were identified in the CCI-20: memory and non-memory complaints. Non-memory complaints were indicative of worse executive function, consistent with PD and ET cognitive profiles. Mood significantly contributed to all CCI-20 dimensions. Future studies should explore the utility of SCCs in predicting cognitive decline in these populations.

Translation, Cultural Adaptation and Validation of Perceived Physical Literacy Instrument-Spanish Version (PPLI-Sp) for Adults

To translate and culturally adapt the Perceived Physical Literacy Instrument (PPLI) questionnaire, as well as to evaluate the factor structure. A single-measure cross-sectional study was conducted. For the first phase of the study, a translation and cultural adaptation of the PPLI questionnaire was carried out, as well as an interview, with the aim of assessing the understanding of the instrument. In the second part of the study, exploratory (EFA) and confirmatory (CFA) factorial analyses were conducted. A total of 213 Spanish adults with a mean age of 27.40 (10.58) participated. EFA was performed because of the good results offered by the sampling adequacy indices (Bartlett test = 1081.848; df = 153; p &lt; 0.001; and KMO test = 0.825). The factor solution comprised three correlated factors:1) physical competence, 2) motivation and confidence, and 3) knowledge and understanding. After the EFA, items 7, 9, 10, 11, 12, 13, 14, 15 and 17 were excluded. Therefore, through CFA, a factor structure of 9 items grouped into three dimensions was extracted. The PPLI-Sp version for adults, obtained from the back-translation process as well as after individual interviews, proved to be valid and reliable after the EFA and CFA analyses, obtaining an instrument of nine items, divided into three dimensions. This instrument can be used to determine the perception of physical literacy among different Spanish adult populations.

Translation, Cultural Adaptation and Validation of Perceived Physical Literacy Instrument-Spanish Version (PPLI-Sp) for Adults.

To translate and culturally adapt the Perceived Physical Literacy Instrument (PPLI) questionnaire, as well as to evaluate the factor structure. A single-measure cross-sectional study was conducted. For the first phase of the study, a translation and cultural adaptation of the PPLI questionnaire was carried out, as well as an interview, with the aim of assessing the understanding of the instrument. In the second part of the study, exploratory (EFA) and confirmatory (CFA) factorial analyses were conducted. A total of 213 Spanish adults with a mean age of 27.40 (10.58) participated. EFA was performed because of the good results offered by the sampling adequacy indices (Bartlett test = 1081.848; df = 153; p < 0.001; and KMO test = 0.825). The factor solution comprised three correlated factors:1) physical competence, 2) motivation and confidence, and 3) knowledge and understanding. After the EFA, items 7, 9, 10, 11, 12, 13, 14, 15 and 17 were excluded. Therefore, through CFA, a factor structure of 9 items grouped into three dimensions was extracted. The PPLI-Sp version for adults, obtained from the back-translation process as well as after individual interviews, proved to be valid and reliable after the EFA and CFA analyses, obtaining an instrument of nine items, divided into three dimensions. This instrument can be used to determine the perception of physical literacy among different Spanish adult populations.

A Confirmatory and an Exploratory Factor Analysis of the Cohen-Mansfield Agitation Inventory (CMAI) in a European Case Series of Patients with Dementia: Results from the RECage Study.

One of the most widely used instruments for assessing agitation in dementia patients is the Cohen-Mansfield Agitation Inventory (CMAI), nevertheless no global score has been proposed. The aim of this study is: (a) to conduct a confirmatory (CFA) and exploratory factor analysis (EFA) of CMAI on people with dementia and Psychological and Behavioral Symptoms (BPSD), and (b) to propose an alternative structure, based on clinical criteria including all CMAI items. Confirmatory and exploratory factor analyses were carried out on the CMAI 29 items administered at baseline to 505 patients with dementia (PwD) and BPSD enrolled in the international observational RECage study. The three-factor structure has not been confirmed by the CFA, whilst the EFA was carried out respectively on 25 items disregarding 4 items with a prevalence ≤5% and then on 20 items disregarding 9 items with a prevalence ≤10%. The four-factor structure explaining 56% of the variance comprised Physically Aggressive behavior, Verbally Aggressive behavior, Physically non-aggressive behavior, and Physically and verbally aggressive behavior. A new grouping of all items according to a clinical criterion is proposed, allowing for a more sensible evaluation of the symptoms leading to better differentiation.

Psychometric Properties of an Instrument to Evaluate Students’ Perception of Learning Objects in Statistics

Digital Learning Resources (DLRs) have the function of facilitating learning; however, the evaluation regarding their functionality is limited since there are few tools for this purpose. Of these, the instrument that stands out is “Perception of the use of Digital Learning Resources in Statistics” (IPDLR-S), which allows for evaluating the perception of undergraduate university students about the functionality of the LDRs. With the objective of providing a tool with scientific quality, the IPDLR-S instrument underwent to an analysis of construct validity and reliability. The instrument was applied to 1,148 university students, the construct validity analysis was performed using an exploratory (EFA) and confirmatory (CFA) factor analysis, and the reliability was determined by ordinal Cronbach’s alpha. According to the EFA, it was found that all the items are represented in the factorial model; however, differences were found for the theoretical model since a fourth dimension emerges (Cooperative Learning). On the other hand, using the CFA, the resulting factorial model showed a good fit (GFI = 0.999, RMSEA = 0.064, CFI = 0.999, and TLI = 0.999). Overall reliability, as well as by factor showed an optimal value (ordinal Cronbach’s alpha &gt; .98). The IPDLR-S instrument has adequate psychometric properties.