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

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.

Systematic assessment of family satisfaction is essential for improving the quality of care in intensive care units (ICUs). The Family Satisfaction with Care in the Intensive Care Unit questionnaire (FS-ICU-24R) is internationally used but has not previously been available in Danish. This study aimed to translate and culturally adapt the FS-ICU-24R into Danish and to evaluate its face and content validity. The translation followed a standardized multistep procedure involving forward translation by six bilingual ICU nurses and researchers, reconciliation through consensus, and blinded back-translation by another bilingual ICU nurse. The Danish version was compared with the original to resolve discrepancies and ensure conceptual equivalence. Face and content validity was assessed through cognitive interviews with six relatives, who completed the questionnaire while verbalizing their understanding of each item. Comments were reviewed by the translator team, and problematic items were revised. The translation process identified linguistic and cultural issues requiring adaptation. Key challenges concerned the Danish legal framework for decision-making, necessitating adjustments to Items #21, #22, and #24 to avoid implying that relatives act as surrogate decision-makers. Item #23 was modified by replacing "control" with "overview/oversight" to reflect the intended meaning without suggesting authority over patient care. Additional adjustments improved clarity and relevance to the Danish context. Cognitive interviews confirmed that the revised items were understandable and acceptable to relatives. The FS-ICU-24R was successfully translated and culturally adapted into Danish using a systematic approach. The Danish version is culturally appropriate and demonstrated good face and content validity. Psychometric evaluation is now warranted to establish its reliability and construct validity in Danish ICU settings.

Patient-centred care is essential for managing Type 2 diabetes, as it relies on understanding patients' experiences and perspectives. However, in Thailand, no culturally adapted patient-reported experience measure (PREM) exists to capture these insights and support quality improvement in diabetes care. To develop and validate a culturally adapted PREM for Thai people with Type 2 diabetes receiving primary care. This mixed-methods study was conducted at Saraphi Hospital, Chiang Mai, from July to December 2024. Stage 1 involved drafting the initial PREM based on a prior scoping review. In Stage 2, content validity was assessed by experts, and face validity was evaluated through patient interviews. Stage 3 involved a quantitative survey of patients to assess construct validity and reliability using exploratory and confirmatory factor analyses. The initial PREM included 37 items across four domains, developed based on findings from the scoping review. After expert and patient feedback, the tool was refined. Exploratory and confirmatory factor analyses confirmed the tool's structure, resulting in a final version with 16 items across four domains: care planning, patient education, professionalism and quality of service. This final PREM structure explained 60.1% of overall variance, and demonstrated good internal consistency (Cronbach's alpha of 0.84), supporting its utility for capturing patient experiences in the Thai healthcare setting. This study developed the first culturally adapted PREM for Thai people living with diabetes. Although further implementation is needed, this current validated tool can support patient-centred care in Thailand and other low- and middle-income settings in Southeast Asia. The development of this instrument actively involved patients throughout key stages. During content validation, individuals living with diabetes participated in an expert panel and provided feedback on item clarity, relevance and comprehensiveness. Their suggestions directly influenced revisions to the questionnaire. For face validity, a pilot test was conducted with patients in a primary care setting, gathering their insights on wording, usability and cultural appropriateness. Their contributions ensured the tool was clear, acceptable and contextually relevant to Thai people living with diabetes.

Validation and cultural adaptation of the Arabic translation of the Fraboni Scale of Ageism.

Psychological factors influence return-to-sport (RTS) decisions after anterior cruciate ligament reconstruction (ACLR). While existing tools measure fear and confidence, none specifically capture athletes' risk-taking tolerance and intentions. This study proposes the development and validation of a scale assessing Risk-taking Intentions and Sport Engagement after ACLR (RISE-ACL scale). Scale development consisted of deductive (literature review) and inductive (expert panel) methods. Eleven experts generated and rated relevant items to be included in the consensus RISE-ACL scale. Content validity was established through expert agreement. For scale validation, 162 ACLR participants, 4-24 months postoperatively (median age 26.5 years; 65% male), completed the newly developed RISE-ACL scale. Criterion validity used a self-rated risk-tolerance scale (0-100%). Construct validity was examined through correlations with the Anterior Cruciate Ligament - Return to Sport after Injury (ACL-RSI) scale and clinical/demographic variables, followed by multivariate modeling. Exploratory factor analysis (principal axis factoring) identified factor structure, and principal component analysis (PCA) explored a short form. Reliability was assessed via Cronbach's alpha and test-retest intraclass correlation coefficient (ICC). Scale development aimed to a 16-item RISE-ACL scale with good content validity (mean agreement 86%), face validity feasibility (mean completion time = 2:05). Criterion validity against the self-rated risk-tolerance scale (0-100%) was moderate and statistically significant (ρ = 0.348, p < 0.001). Construct validity analyses showed that in multivariate modeling, only ACL-RSI remained a statistically significant independent predictor of RISE-ACL scores (Wald χ2 = 6.36, p = 0.012). Factor analysis yielded three interpretable factors (1) External Pressure, (2) Internal Pressure/Defiance, and (3) Urgency-explaining 47.72% of variance. Factor 3 correlated most with self-perceived risk-taking (ρ = 0.340), and Factor 2 most negatively with ACL-RSI (ρ = -0.166). Reliability showed good internal consistency (Cronbach's α = 0.84) and test-retest reliability (ICC = 0.84). A 6-item short form was proposed, showing a strong correlation with the total score (ρ = 0.891). The RISE-ACL is a 16-item self-administered scale designed to assess patients' risk-taking intentions during return to sport after ACLR. Validation demonstrated it is a reliable and valid tool, supporting shared decision-making to enhance RTS quality. NCT06748066 LEVEL OF EVIDENCE: II.

This study developed and validated the Fears Towards Generative Artificial Intelligence scale, a novel instrument assessing individuals' concerns about emerging generative AI technologies, which are increasingly integrated into daily life. Drawing on qualitative data from three focus groups and subsequent quantitative validation with 303 participants, we initially derived 37 items that captured diverse fears, including concerns about job displacement, social inequalities, and loss of human autonomy commonly associated with generative AI systems. Exploratory factor analyses supported a unidimensional structure of the scale, demonstrating strong reliability and content validity. Regression models revealed that negative attitudes towards AI and perceived threats to employment were key predictors of heightened fear, while greater usage and familiarity were linked to reduced fear. We also present a short 4-item version of the scale generated by a genetic algorithm and tested with 101 new participants, which presents good psychometric properties. The FTGAI scale addresses a critical measurement gap and offers a comprehensive tool for researchers and policymakers seeking to understand and mitigate fears towards generative AI's growing societal impact.

Cross-Cultural Validation of the Brazilian-Portuguese Oral Health Impact Profile for Temporomandibular Disorders.

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

Multiple sclerosis (MS) is an autoimmune-mediated neurodegenerative disorder. The UnitedStates Food and Drug Administration recommends using clinical outcome assessments (COAs) to measure concepts that matter to patients in clinical trials and to document the content validity of the COAs using conceptual models of patient experience. This study aimed to explore and document the patient experience of signs, symptoms, and health-related quality of life impacts of relapsing-remitting MS (RRMS) and primary progressive MS (PPMS) to inform future COA validation research. We conducted a targeted literature review (TLR) and qualitative semi-structured interviews of patients with RRMS and PPMS in the United States of America (USA). Publications and interview transcripts were analyzed, synthesized, and inductively categorized to develop a conceptual model of patient experiences of RRMS and PPMS. Ten publications were reviewed as part of the TLR, and 16 participants (RRMS, n = 7; PPMS, n = 9) were interviewed. Most participants reported fatigue, muscle weakness, difficulty walking, sleep disturbance, and bladder issues. Many participants experienced negative emotional, physical, and social impacts due to the disease. Most participants also described needing to rest and plan/avoid activities, as well as requiring support from their family to manage their symptoms. This study highlights the multidimensional burden of living with RRMS and PPMS. A provisional conceptual model was developed, harmonizing the TLR and interview findings. This conceptual model may be used to promote a better understanding of the patient experience of RRMS and PPMS and to evaluate the content validity of COAs during the development of new drug treatments.

The purpose of this study was to determine the effect of Gamification on Word Recognition Skills of pupils with Attention Deficit Hyperactivity Disorder (ADHD) in Calabar Municipality. To achieve this purpose, two research questions and two research hypotheses were formulated to guide the study. The study employed the quasi-experimental research design using pre-test-post-test non-randomized control group design. The population of the study comprised 104 Attention Deficit Hyperactivity primary one pupils in the 23 public schools in Calabar Municipality. A sample size of 47 ADHD pupils in three intact classes were used in the study. Three public primary schools in Calabar Municipality were randomly sampled using Cap and Draw method and all the ADHD pupils in the three schools participated in the study. Adapted Attention Deficit hyperactivity disorder (ADHD) diagnostic checklist, Pupils performance test on Word Recognition Activity Test (WRAT) and Instructional (treatment) package on Go-Fish Game were the instruments used for data collection. The instruments was subjected to face and content validation by three specialists and yielded a reliability Co-efficient of .86. Mean and standard deviation were used for answering research questions while Analysis of Co-Variance (ANCOVA) was used to test the hypotheses at .05 level of significance. The results of the analysis revealed significant difference in academic performance of ADHD pupils taught picture clues with the help of Go-Fish Game. The reading game was found to be more effective in improving ADHD pupils’ word recognition skills. There was no significant difference in word recognition skills given their cognitive ability levels. Some recommendations were made to include that teachers should embrace the 21st century skills by effectively using diverse instructional language games to stimulate the desire to learn among pupils with ADHD so as to conquer their academic deficiencies and challenges.

Present study aimed to examine the effect of formative assessment techniques on students’ performance in the subject of English at elementary level. Nature of present study was quantitative. Quasi experimental pre-test-post-test non-equivalent control group design was employed. Two intact groups (experimental and control) were selected on convenient basis to conduct the experiment. The experimental group received treatment, and the control group was taught by traditional teaching method. Pilot study was carried out to ensure the content validity and item analysis of achievement test. The data collected were analyzed using inferential statistics, specifically independent and paired samples t-tests, to test the hypotheses. The study findings revealed that formative assessment techniques are more successful at improving students’ performance in the subject of English. Students who used formative assessment techniques outperformed those who learned English through the conventional lecture method. Findings of the study revealed that there was significant mean difference between the performance of experiment and control group students in English. Experimental group performed better after treatment as compared to the control group. It is recommended that improvements in English by using formative assessment techniques will eventually contribute to an improvement in elementary school students' academic performance.

Mental Imagery is the process of creating or re-creating an experience in a person’s mind by employing all the senses. The Mental Imagery Scale was developed based on established theoretical and measurement frameworks in the field of mental imagery, including seminal work on vividness of visual imagery, early psychometric approaches to imagery assessment, and dual-coding theory emphasizing the interaction between verbal and visual cognitive systems. The main objective of the present study was to construct and standardize a Mental Imagery Scale for measuring Mental Imagery of Secondary Level Students. The researcher constructed the draft Mental Imagery Scale consisted of 90 items using 3-point rating scale on the basis of 6 (three) selected areas of mental imagery. These are viz. Visual, Auditory, Gustatory, Olfactory, Tactual and Bodily imagery. All the 6 areas of mental imagery included 2 dimensions: Vividness of Mental Images and Clarity of Mental Images. The draft Mental Imagery Scale was consisted of 90 statements which were subjected to 5 experts’ suggestions. On the basis of the suggestions and recommendations of experts 11 items were dropped, the out the remaining selected 79 items, 9 items were partially modified. The draft Mental Imagery Scale was administered on a sample of 158 Secondary Level Students for item analysis. The final draft Mental Imagery Scale which was administered on 134 sample Secondary level students from 1 Government Secondary school (76= Boys 30+Girls 46), from 1 Private Secondary school (58= Boys 32, Girls 26). The study was limited to secondary-level students from selected Government and Private schools of Namsai District, Arunachal Pradesh. In the present study, t-value was calculated for the final selection of the items. The items having which yielded t-value 1.75 or more were retained to include in the final version of the Mental Imagery Scale for Secondary level. The statements of this scale were constructed in both English and Hindi language. The final scale consisted of 70 statements using 3-point rating scale on the basis of 6 (three) selected areas of mental imagery. The Split-half reliability coefficient of the scale was found to be .88, the Test-retest reliability coefficient was found to be .78 and the Cronbach Alpha reliability coefficient was found to be .79. In order to determine the validity of this scale, the researcher presented it to a number of experts in the field of seeking judgement regarding the content coverage of the scale and it was considered to have satisfactory content validity. The results suggest that the Mental Imagery Scale is a reliable and content-valid instrument for measuring mental imagery among secondary level students and may be effectively used for research and educational purposes.

Very few validated instruments measure a child's concept of pain. The Conceptualization of Pain Questionnaire (COPAQ) is a unidimensional instrument measuring this construct, developed in Catalan and translated to English. The psychometric properties of the English-version have not been evaluated. We conducted a Rasch analysis to evaluate its structural validity and internal consistency and a Confirmatory Factor Analysis (CFA) to evaluate its structural validity. We analysed an existing dataset from a previous study. Item fit was evaluated using INFIT and OUTFIT statistics, item difficulty was estimated using Rasch coefficients, and internal consistency using Cronbach's alpha. Structural validity was measured using item loadings from the CFA. We included data from 497 adolescents (average age 14y [SD 1.28], 51% male). There was a wide range of difficulty across items. One item demonstrated excessive positive outfit, and two items were close to the cut-off for excessive negative outfit. The COPAQ demonstrated poor overall fit to the unidimensional Rasch Model and did not demonstrate adequate internal consistency (Cronbach's alpha=0.6). Results from the CFA suggest the items do not measure the single construct they intend to measure. The English-version of the COPAQ did not have adequate internal consistency or structural validity. More work is required to assess the content validity of current instruments measuring a child's concept of pain. Developing validated instruments measuring a child's concept of pain aligned with the biopsychosocial model should be prioritized.

Assessment of Micro-TRAIN simulation in otologic microsurgery.

This study aimed to translate the Nurse Prescribing Self-Efficacy Scale (NP-SES) into Chinese and evaluate its reliability and validity. A systematic methodological framework was used. The study's setting was hospitals and nursing schools in Jiangsu province, China. A convenience sample of 309 practising nurses and nursing graduates was recruited. The reliability and validity of the scale were assessed. Item screening was based on critical ratio values and item-total correlation coefficients. Validity was evaluated through content validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed using Cronbach's α coefficient and split-half reliability. EFA identified three common factors, accounting for 78.608% of the total variance. CFA indicated that model fit indices met acceptable thresholds, supporting the scale's structural validity. Cronbach's α and split-half reliability for subdimensions ranged from 0.907 to 0.957 and from 0.867 to 0.944, respectively. The Chinese version of the NP-SES demonstrates good reliability and validity and is suitable for assessing clinical nurses' self-efficacy in prescribing.

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.

Objectives: To describe the process of developing a protocol for administering bronchodilator therapy via metered-dose inhaler to patients undergoing mechanical ventilation (MV). Methods: This is a qualitative, descriptive study in the form of an experience report. The development process occurred in five stages: 1) literature review; 2) construct elaboration; 3) content and face validation; 4) methodological quality assessment; and 5) protocol publication. Results: In the first stage, 23 studies were selected. Data extracted from the review served as the basis for the protocol recommendations. In stage 2, four documents were used as methodological references for guideline and protocol development. Based on these documents, the main elements frequently cited were identified, and the first version of the protocol was drafted. The third stage consisted of two rounds of validation: the first involved assessment by four experts, and the second by healthcare professionals (n = 35). In both rounds, the validity index exceeded 0.95 (excellent). In stage 4, the protocol’s methodological quality was evaluated by three PhD professors using the Appraisal of Guidelines for Research &amp; Evaluation II instrument. Six quality domains were assessed. Five domains achieved scores above 90%, and one domain scored 68.52%. In the final stage, the protocol was formatted and published. Conclusions: The developed protocol is expected to provide support and recommendations enabling healthcare professionals to correctly administer inhaled medications during MV.

Content Validation of Badminton Training Program Model for Young Athletes

BackgroundSocio-economic changes and evolving family structures have created unique caregiving challenges in China, highlighting the need for tools to systematically measure child care deficits. This study aims to develop and preliminarily validate the Inadequate Child Care Scale (ICCS), a culturally relevant instrument designed to measure deficits in child care specific to the Chinese context.MethodsThe development and validation of the Inadequate Child Care Scale (ICCS) were conducted through a three-phase process. Phase One involved the generation of an initial item pool informed by a prior grounded theory study. Phase Two included nationwide data collection via a structured survey administered to participants across diverse regions in China. Phase Three focused on evaluating the psychometric properties of the ICCS using Exploratory Factor Analysis (EFA; n = 468) and Confirmatory Factor Analysis (CFA; n = 702), with an emphasis on assessing convergent validity, discriminant validity, and composite reliability.ResultsThe initial item pool comprised 32 items, 30 of which were retained following expert evaluation for content validity. EFA revealed a four-factor structure underlying the scale: Inadequate Daily Life Care, Inadequate Psychological and Emotional Care, Inadequate Safety Care, and Inadequate Educational Care, encompassing 30 items in total. CFA supported the factorial validity of the ICCS, yielding favorable model fit indices (GFI = 0.929, CFI = 0.977, TLI = 0.975, RMSEA = 0.038, χ²/df = 2.025). The scale demonstrated strong internal consistency (Cronbach’s alpha > 0.80) and acceptable test-retest reliability.ConclusionThe ICCS is a psychometrically sound tool for assessing child care deficits in China. Its development fills a critical gap in child care research and provides a foundation for targeted interventions and policy reforms. Future studies should refine the scale further and explore its applications in broader caregiving contexts.