A modified urodynamic quality control quick checklist for pediatrics: Reducing technical artifacts to enhance assessment reliability.

Introduction: Children with spastic diplegic cerebral palsy present with multidomain functional limitations that require structured physiotherapy interventions tailored to Gross Motor Function Classification System (GMFCS) levels. Establishing content validity is essential to ensure that such protocols are clear, relevant, and clinically appropriate. Aim: To establish the content validity of a multidomain physiotherapy protocol developed for children across GMFCS levels I-V. Materials and Methods: A cross-sectional methodological content validation study was conducted at the Department of Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India, from June 2025 to November 2025. A comprehensive multidomain physiotherapy protocol comprising 30 items across Stability, Mobility, Strength, Endurance, Cognitive, and Respiratory domains for GMFCS levels I-V was evaluated. Nine experts in paediatric neurorehabilitation independently rated each item for relevance, clarity, and appropriateness using a four-point ordinal scale. Quantitative content validity analysis was performed by calculating the Item-level Content Validity Index (I-CVI) and Scale-level Content Validity Indices (S-CVI/ AVE and S-CVI/UA). Results: The I-CVI values ranged from 0.78 to 1.00 across domains. S-CVI/AVE values demonstrated high agreement (0.89-1.00). While most S-CVI/UA values ranged from 0.80 to 1.00, a lower S-CVI/UA value of 0.40 was observed as an outlier in the respiratory domain, reflecting partial lack of universal agreement among experts. Conclusion: The developed physiotherapy protocol demonstrated excellent content validity, supporting its clarity, relevance, and clinical appropriateness for use across all GMFCS levels.

Development and validation of the Malaysia adolescents e-cigarette survey (MY-ACES).

In Türkiye, healthcare providers are required to assess the competence of primary care workers in breastfeeding to improve practices and patient outcomes. However, a valid and reliable tool for evaluating breastfeeding competence in Turkish healthcare settings is lacking. The aim of this study was to translate the Breastfeeding Competence in Primary Care from Catalan into Turkish and to assess the reliability and validity of the Turkish version of Breastfeeding Competence in Primary Care. A methodological study testing the Turkish validity and reliability of the Breastfeeding Competence in Primary Care scale with 362 healthcare professionals working in primary health care settings. Language adaptation of the scale was achieved using the forward-backward translation method. Content, face, and construct validity were used for validity analysis; item analysis, Cronbach's alpha, and test-retest correlation were used for reliability analysis. Content Validity Index was 0.82. As a result of factor analysis, four items were removed and a single-factor structure explaining 55.34% of the total variance was obtained. Confirmatory factor analysis indicated mixed model fit (χ2/df = 5.683; GFI = 0.769; AGFI = 0.703; CFI = 0.941; RMR = 0.082; NFI = 0.929; TLI = 0.931; IFI = 0.941; RMSEA = 0.114), as the RMSEA value indicated poor fit despite acceptable values for several other indices. Cronbach's alpha value was 0.95 and the test-retest correlation coefficient was r = 0.79; p < 0.001. The results of this study show that the Turkish version of the Breastfeeding Competence in Primary Care is valid and reliable. It can be said that the scale can be used to evaluate the knowledge and competencies of health professionals in primary care about breastfeeding.

The asthma diary has been established as a self-management tool to help patients achieve good disease control. However, asthma diary compliance is low, indicating a need to assess the diary's usability. Given the scarcity of a validated tool for assessing asthma diary usability, this study aims to adapt the Malay version of the mHealth App Usability Questionnaire (M-MAUQ) into the Asthma Diary Usability Questionnaire (ADU-Q) (Malay) and to assess its psychometric properties. In the first phase, the M-MAUQ items were adapted and rearranged into the four domains of the Nielsen usability model. In the second phase, content validity was assessed in two stages: domain validation by 3 experts, followed by item content validation by 7 experts. Face validation was then conducted by 10 patients with asthma. In the third phase, a cross-sectional study of 115 asthma patients attending the primary care clinic and the respiratory clinic follow-up was conducted. All patients completed the ADU-Q (Malay), and 62 patients were contacted 2 weeks later to complete the ADU-Q again. Exploratory factor analysis was performed with promax rotation, while reliability was assessed using Cronbach's alpha and the intraclass correlation coefficient. The item content validity index was 1.0, and item face validity indices ranged from 0.9 to 1.0. Exploratory factor analysis identified a three-factor structure with factor loadings >0.5 for all items; corrected item-total correlations exceeded 0.5, Cronbach's alpha was 0.982, and the intraclass correlation coefficient was 0.988, demonstrating excellent internal consistency and test-retest reliability. Based on these findings, ADU-Q is a valid, reliable and stable tool for assessing the usability of an asthma diary among adults with asthma.

This paper aimed to assess the test construction skills of science teachers in public secondary schools in Dagupan City, to establish a foundation for improving current assessment practices. The research was anchored on national and international policies such as the UNESCO Education 2030 Framework, assessment practices of the OECD, and DepEd Order No. 31, s 2020, which concentrated on assessing teachers' competency in the area of test construction and in strengthening classroom assessments. The study covered several aspects of interest: (1) Teachers' profile in terms of academic qualifications, specialization, years of teaching, position, grade level assignment and relevant courses attended; (2) their competency levels in items construction across the four key domains of Item Development (ID), Content Alignment (CA), Cognitive Demand (CD), and Distractor Effectiveness (DE); (3) relationship between teachers' profile and competency levels, (4) expert-based rating of competency in Earth Science, Biology, Chemistry and Physics; (5) challenges encountered in items development process; and (6) propose a framework of improving competency in items construction. A cross-sectional study of 84 secondary science teachers was conducted, using a survey questionnaire and CVI evaluation of teacher-made tests. The results revealed that most teachers held Master's degrees and specialized in General Science and Biology. Their competency was highest in Item Development (M = 3.69) and Content Alignment (M = 3.65), with moderate competency in Cognitive Demand (M = 3.44) and Distractor Effectiveness (M = 3.40). Test construction competence showed a positive correlation with educational level, teaching experience, position, and training, but not with subject area or grade level. Content Validity Index (CVI) scores indicated that Senior High School (SHS) teachers performed better (mean CVI = 0.85) than Junior High School (JHS) teachers (mean CVI = 0.79), with Chemistry performing the weakest in both groups. Barriers to effective test construction included lack of time (76.2%), insufficient training (67.9%), difficulty writing distractors (64.3%), and challenges in assessing higher-order thinking (57.1%). The study recommends expanding training programs, providing additional resources, enhancing time management strategies, and establishing mentorship programs. Additionally, it suggests implementing a developmental framework to improve test construction practices, particularly in subjects like Chemistry and Physics.

This study aimed to develop the Comprehensive School Readiness Assessment Scale (COSRAS), a multidimensional instrument designed to evaluate school readiness in children aged 57–72 months. Scale development followed DeVellis’s framework. An initial item pool of 216 items was generated based on developmental, learning-related, and functional school readiness constructs and subsequently refined through expert review to 182 items. The finalized scale was completed by teachers of 1813 children, and test–retest reliability data were obtained from 386 teachers. Content validity indices were high, ranging from 0.892 to 1.000. Exploratory and confirmatory factor analyses supported the proposed eight-factor structure, demonstrating excellent model fit (CFI = 0.999; RMSEA = 0.000–0.009). Convergent validity with the Primary School Readiness Scale was strong (r = 0.665–0.695). The internal consistency of the scale was excellent across all domains (α = 0.916–0.969), and test–retest reliability was high (ICC > 0.990). COSRAS demonstrates strong psychometric properties and provides a comprehensive assessment of school readiness by integrating developmental competencies, learning-related skills, and functional performance. The scale enables early identification of children who may be at risk for neurodevelopmental or learning-related challenges before school entry. COSRAS may assist educators and allied professionals in early childhood and school-based settings by offering domain-specific profiles that inform instructional planning, individualized supports, and early intervention strategies.

This study aimed to translate and validate the Arabic version of the Orthorexia Nervosa Inventory (ONI) scale to assess orthorexia nervosa (OrNe) among young Arabic-speaking adults in the UAE and explore the relationship between OrNe and various sociodemographic factors. A total of 625 young adult participants (88.2% female) completed a questionnaire comprising the ONI scale and sociodemographic questions. The study assessed internal reliability using Cronbach's α, external reliability using intraclass correlation coefficient (ICC), content validity using a panel of 12 experts, Known-Group validity using associations between OrNe classification and demographics, and structural validity using confirmatory factor analysis. The Arabic ONI scale showed high internal (Cronbach's α = 0.934) and external (ICC = 0.849) reliability. Content validity was excellent (scale-level content validity index = 0.96). Vegetarians had significantly higher ONI scores, indicating good Known-Group validity. The model fit indices (χ2/df = 1.663, comparative fit index = 0.993, Tucker-Lewis index = 0.992, goodness-of-fit index = 0.989, root mean square error of approximation = 0.033, standardized root mean square residual = 0.049) reflected excellent structural validity. The Arabic ONI scale is a reliable and valid tool for assessing OrNe tendencies in young Arabic-speaking adults. Future studies should explore its applicability to broader populations and investigate predictors of OrNe tendencies. Level V, descriptive cross-sectional study.

Measles remains a global health threat, and rising vaccine hesitancy in Malaysia underscores the need for locally tailored communication strategies to strengthen public trust and vaccination. This current research developed and validated the Parental Health Education (PaHE)-Measles toolkit, grounded in the Health Belief Model, to support parental confidence and the uptake of measles, mumps, and rubella (MMR) vaccination in Malaysia through a four-stage process: information gathering, preliminary adaptation design, preliminary adaptation testing, and adaptation refinement. Five multidisciplinary experts validated its content both in Malay and English, and 10 health care providers confirmed overall quality. The acceptability was assessed among 30 end-users. The PaHE-Measles achieved a Content Validity Index (CVI) score of 1.0 from expert reviewers, whereas health care providers rated its understandability and actionability more than 80%. End-users reported an average score of over 9.0. In conclusion, PaHE-Measles is a valid and ready toolkit for educating parents, countering misinformation, and strengthening vaccine confidence.

PurposeChronic kidney disease (CKD) is a global public health priority. Adherence to complex therapeutic regimens is crucial for non-dialysis patients. However, the absence of multidimensional assessment instruments has impeded precise adherence evaluation and targeted interventions. This study aimed to develop and validate a disease-specific Treatment Adherence Scale for Non-Dialysis CKD Patients (TAS-NCKD).MethodsA cross-sectional mixed-methods study was conducted in China. Preliminary items were developed by a scoping review and two Delphi expert rounds. Three rounds of surveys (n=160, 350, and 370) were conducted for the construction and psychometric validation of the scale. Feasibility, reliability, validity, discrimination and difficulty, and optimal cutoff determination was verified.ResultsThe third validation cohort consisted of 181 patients with CKD stage 1, 49 with stage 2, 59 with stage 3, 38 with stage 4, and 43 with stage 5. The final TAS-NCKD comprises 45 items across 5 dimensions. The scale demonstrated high feasibility with a completion rate of 92.5%, and a completion time within 18 minutes. The Cronbach’s α, split-half reliability, test-retest reliability for the scale were 0.955, 0.968, and 0.836. The scale-level content validity index (CVI) and item-level CVI were 0.992 and 0.875–1. Confirmatory factor analysis showed a good model fit. Convergent and discriminant validity both met the standards. Item characteristic curves were ideal and the optimal cutoff was established at 179 points.ConclusionThe TAS-NCKD is a valid and reliable instrument for assessing treatment adherence in Chinese non-dialysis CKD patients. This study provides targeted insights for improving patient self-management and may help slow disease progression.

Collaborative problem-solving is essential in mathematics education, yet many students face challenges due to a lack of effective assessment tools that adequately measure these skills. The existing approaches often overlook the integration of structured assessments, resulting in a significant gap in understanding how to cultivate and evaluate collaborative problem-solving abilities in students. This study aims to address these identified issues by developing a collaborative problem-solving instrument grounded in a skills-based rubric specifically for mathematics learning. Using a Research and Development (R&amp;D) approach following the procedural framework of Borg and Gall, the study created a comprehensive assessment tool designed to enhance the measurement of collaborative problem-solving skills. Validation through Lawshe’s formula resulted in a content validity index of 0.99, confirming the instrument’s reliability. Practicality testing involved questionnaires distributed to middle school mathematics teachers, achieving a positive response rate of 92.46% in small-scale trials and an impressive 97.61% in large-scale field trials. These findings demonstrate the instrument’s effectiveness and practical applicability in classroom settings. The implications indicate that incorporating this structured assessment can significantly improve students’ collaborative problem-solving abilities, ultimately enhancing their engagement and learning outcomes in mathematics. Future research should explore the broader applicability of this instrument across various educational contexts and subjects to maximize its impact.

The Problematic Experience of Therapy Scale (PETS) identifies barriers to home-based exercise programs but has not been validated in hand therapy populations. This study aimed to translate the extended PETS into Swedish and evaluate its content and construct validity in patients undergoing early sensory relearning following peripheral nerve injury. The PETS was translated into Swedish (PETS-Swe) following established cross-cultural adaptation guidelines. Fifty-three patients with peripheral nerve injuries completed the PETS-Swe four weeks into a home-based sensory relearning program. Exercise adherence was monitored using a daily exercise diary. Content validity was assessed through expert review (face validity) and patient ratings of item relevance, clarity, and ambiguity. Item-level (I-CVI) and scale-level (SCVI) content validity indices were calculated, alongside modified kappa statistics for interrater agreement. Construct validity was examined using Spearman's correlation between PETS-Swe scores and reported exercise frequency. Translation revealed no major discrepancies. Most items demonstrated high content validity (I-CVI and S-CVI >0.8), though lower relevance scores were observed in the technical subscale (I-CVI: 0.65-0.69). Interrater agreement was good to excellent across all items (K >0.74 for items 1-17; K = 0.6-0.74 for items 18-20). Expert reviewers confirmed strong face validity. Moderate negative correlations were found between PETS-Swe scores and exercise adherence (rho = -0.40 to exercise log; -0.57 to diary), supporting construct validity. The Swedish version of the extended PETS is a valid tool for identifying barriers to home-based sensory relearning in patients with peripheral nerve injuries undergoing hand therapy.

This study reports on content validity and interrater reliability of the Awake States Indicators Checklist (ASIC) in pediatrics. NeuroRelational Framework clinicians (n = 16) rated the biobehavioral indicators’ clarity, relevance, and comprehensiveness. Item-level and scale-level content validity index ratings were high. Two interns rated 50 short video clips. Results demonstrated high interrater reliability on arousal states (Cohen’s Kappa = 0.90, p<.001) and acceptable to good across the biobehavioral indicators (45% to 100% agreement, with over 80% agreement in most categories). The ASIC demonstrates good preliminary psychometric properties supporting use in transdisciplinary, transdiagnostic practice. Findings are limited by small samples and lack of diversity.

Introduction: Coronary heart disease (CHD) is a leading cause of mortality among the elderly. Promoting healthy lifestyles through balanced diets and regular physical activity is essential for prevention programs. However, the availability of standardized and validated instruments to measure knowledge of healthy lifestyles among elderly individuals is still limited, particularly in Indonesia. This study aimed to develop and validate a knowledge questionnaire focusing on diet and physical activity for elderly individuals at risk of CVD. Methods: A mixed-method validation was conducted, involving qualitative and quantitative approaches. First, content validity was assessed by experts in community nutrition, clinical nutrition, and sport nutrition (n = 8) using the Content Validity Index (CVI) and multi-rates Kappa statistics. Second, face validity was tested with elderly participants (n = 10) to ensure clarity and comprehension. Finally, item validity and reliability testing were examined with elderly participants (n = 30) using the Pearson correlation test between item-total score and Cronbach’s Alpha to determine internal consistency. Results: The I-CVI values for all items ranged from 0,75 to 1,00, and Kappa statistics from 0,72 to 1,00, indicating good to excellent agreement among experts. Face validation confirmed that most items were relevant and understandable, with brief wording adjustments required for clarity. The Cronbach’s alpha of 0,742 reflected good internal consistency. Overall, the validation process demonstrated that 19 of 28 items met the statistical criteria. Conclusion: The healthy lifestyle knowledge questionnaire demonstrated strong validity and reliability in assessing knowledge among elderly individuals at risk of CHD. This instrument is practical and applicable for supporting health promotion and prevention programs focusing on diet and physical activity.

INTRODUCTION: Musculoskeletal diseases (MSDs) are associated with prolonged uncomfortable postures and repetitive actions. The purpose of this study was to develop and validate a structured interprofessional dental ergonomics (IDE) module that could be added to the dental curriculum to address these issues. MATERIALS AND METHODS: The study comprised three phases: i) Needs assessment, ii) Instructional module development, and iii) Validation. Guidelines, relevant literature, and the findings of the needs assessment served as the foundation for the ergonomic module development, which comprised 6 units: i) human factors and ergonomics, ii) basic dental ergonomics, iii) operator positioning, iv) dental team ergonomics, v) workstation design, and vi) ergonomic practices like working smart and short breaks. The module content validity index and reliability were evaluated and verified by 7 experts. 103 dental professionals represented by 42 dental practitioners, 35 dental students, and 26 faculty members, completed a self-administered questionnaire on IDE. RESULTS: Overall, 87% of respondents valued microbreaks, 92% strongly agreed that ergonomics should be taught in schools, and 57% said that MSDs affected their day-to-day job. The expert panel firmly agreed that the module could improve knowledge and that it was acceptable. The module's good content and face validity were supported by the validation findings. CONCLUSION: The developed IDE module demonstrated both useful content and face validity. Dental students' knowledge, comprehension, and skills to prevent MSDs can be improved by incorporating this into dentistry education, supporting better health and well-being.

Developing and validating a comprehensive nutrition literacy scale for older adults: addressing the modern challenges of nutritional health in the digital era.

A validity and reliability study of the care challenge scale (CCS) among turkish caregivers of patients with Alzheimer's disease.

Cancer survivorship begins at diagnosis. Transition expectation is a key modifiable factor that shapes adolescents' movement from adolescence to adult care and is a prerequisite for successful transition and better survival outcomes. This study aimed to translate the Transition Expectation Scale (TES) into Chinese (TES-CN) and address its psychometric properties in pediatric cancer survivors (PCSs). We used a two-phase design. First, the TES was translated and culturally adapted into Chinese in accordance with guidelines. Second, a cross-sectional psychometric evaluation was conducted in a convenience sample of Chinese PCSs. Reliability and validity were examined. Two hundred and seventeen PCSs were recruited for psychometric evaluation. The Content validity of the TES-CN was satisfactory, with a scale-level content validity index of 0.91 and an item-level content validity index ranging from 0.78 to 1.00. Exploratory and confirmatory factor analyses supported an 11-item, three-factor structure explaining 64.3% of the variance. Compared to the original single-factor structure, the three-factor model demonstrated a better fit (Δχ2=116.58, Δdf=13, p<0.001). The convergent and discriminant validity results also jointly indicated that the three constructs were empirically distinct, and the model exhibited satisfactory construct validity. The TES-CN had good reliability, with a Cronbach's alpha of 0.89 and test-retest coefficients ranging from 0.60 to 0.94, indicating acceptable to excellent temporal stability. The TES-CN is a reliable and valid tool for assessing transition expectations among Chinese PCSs and can be used in Chinese research and clinical settings.

Development and initial content and face validation of a questionnaire to evaluate pharmacists' attitudes and practices in counselling urinary tract infection patients: A mixed methods study.

Introduction: Bipolar Disorder (BD) is a complex psychiatric mood disorder. Despite its complexity, nearly half of the patients experience medication non adherence due to poor insight into the illness. Therefore, improving patient knowledge using a Patient Information Leaflet (PIL) regarding the disease and its treatment is crucial. Aim: To develop and validate a PIL and to assess knowledge levels among patients with BD. Materials and Methods: A prospective quasi-experimental study was conducted from June 2025 to November 2025 at Justice KS Hegde Charitable Hospital (JKSHCH), Dakshina Kannada, India. A total of 42 patients with BD aged 18 years or older were included. Demographic details, including age, gender, education, and domiciliary status were collected for analysis. The PIL was developed using information from relevant literature and translated into regional languages. Content validity was assessed using the Content Validity Index (CVI). Readability was evaluated using the Flesch Reading Ease (FRE) and FleschKincaid Grade Level (FKGL) formulas. The design quality was assessed using the Baker-Able Leaflet Design (BALD) criteria. The reliability of the Patient Knowledge Questionnaire (PKQ) was determined using the Intraclass Correlation Coefficient (ICC). A paired t-test was performed using Statistical Package for the Social Sciences (SPSS) version 29.0 to compare knowledge levels before and after reading the PIL. A p-value&lt;0.05 was considered as statistically significant. Results: The PIL achieved CVI scores of 0.93 for relevance and 0.91 for clarity, indicating excellent content validity. Readability scores of 83.3 (FRE) and 2.8 (FKGL) suggest that the leaflet can be easily understood by individuals with education beyond grade three. BALD scores were 28 in English and 26 each in Kannada and Malayalam, indicating good leaflet design. ICC values ranged from 0.6 to 1 across questionnaire versions, demonstrating high reliability. The post-test results results showed a significant improvement in patient knowledge after reading the PIL. Conclusion: The systematically developed and validated PIL effectively improves patients’ understanding of BD and its treatment, which may enhance medication adherence and quality of life.