Test-retest Reliability Correlation Research Articles

Development and Validation of a New Tool to Measure Performance Knowledge and Communication Skill of Multidisciplinary Health Science Learners on Radiation Emergency Preparedness and Response Management.

The purpose of the study was to design, develop, and validate a newer tool on radiation emergency preparedness responses (RadEM-PREM IPE tool) to measure communication, knowledge, performance skills in multidisciplinary health science learners. The study design is a prospective, single centric, pilot study. Five subject experts designed, analyzed, and selected items of the instrument for relevant content and domain. Psychometrics that the tool assessed were content validity, internal consistency, test-retest reliability, and intraclass correlation coefficient. Twenty-eight participants completed test-retest reliability for validation of 21 sorted out items calculated percentage of agreement >70% I-CVI/UA (item content validity index with universal acceptability) and S-CVI/UA (scale content validity index with universal agreement method). Items with percentage agreement >70% and I-CVI over 0.80 were kept, ranged from 0.70 to 0.78 were revised, and below 0.70 were rejected. Items with kappa values ranging from 0.04 to 0.59 were revised and ≥0.74 were retained. Internal consistency assessed using Cronbach's alpha was 0.449. Positive correlation between attitude and communication (r = 0.448), between performance and communication (r = 0.443) were statistically significant at 0.01 level. Overall, intraclass correlation coefficient for all the measures is 0.646, which is statistically significant at 0.05 level (P < 0.05). Study concludes that the RadEM-PREM IPE tool would be a new measuring tool to assess knowledge, performance, and communication skills of interprofessional radiation emergency response team learner's evaluation.

A borderline personality assessment for adolescents: Validity and reliability of the Chinese languages borderline personality features scale (short form version) for adolescents/children.

Borderline personality disorder (BPD) is characterized by behavioral patterns that promote suffering in many adolescents and their guardians. Currently, early diagnosis of BPD mainly depends on the effective assessment of pathological personality traits (i.e., borderline personality features) and using the indicated scales. The Borderline Personality Features Scale for Children-Short Form (BPFSC-SF) is widely used and the introduction of a Chinese version of the BPFSC-SF, can improve the diagnosis and prognosis of Chinese patients with BPD. The aim of the present study was to assess the validity and reliability of the Chinese version of the BPFSC-SF. 120 adolescents with BPD were enrolled in the present study and completed the BPFSC-SF and the Personality Belief Questionnaire-Short Form (PBQ-SF) assessments. Confirmatory factor analysis (CFA) was used to test assessment validity. Test-retest correlations and the Cronbach's α coefficients were used to determine reliability. CFA analysis identified primary factors of BPFSC, with each item ranging from 0.597~0.899. The Spearman rank correlation coefficient was 0.877 between CL-BFSFC-SF and the state vs. trait loneliness scale. The Cronbach's α of the scale was 0.854 in the clinical group. The test-retest reliability correlation coefficient (interclass correlation coefficients.ICC) was 0.937. The Chinese version of BPFSC-SF is a valid and reliable tool for adolescent Chinese patients with BPD.

Automated Detection of Horizontal Strabismus and Home Control Evaluation Using a Mobile Phone App

Purpose: To evaluate the reliability, validity, and usability of a mobile phone app that captures facial images to identify strabismus.Methods: We enrolled patients who visited our pediatric strabismus clinic and provided consent for participation in the study. The facial photographs of the patients were automatically captured by the app. The app used the photographs to identify ocular misalignment based on the comparison of the positions of the corneal reflex and limbus of both eyes. The results from the app were compared to the physician’s diagnosis. Intraclass correlation coefficients were used to assess the test-retest and interrater reliability of the app. Additionally, the guardians captured photographs of the patients through this app for 1 month at home to evaluate the frequency of manifest exotropia at home. And the results were compared to those of other strabismus control scales.Results: A total of 103 patients were enrolled and 10 patients were enrolled for the home control test. Based on the physician’s diagnosis, the sensitivity, specificity, positive predictive value, and negative predictive value of the app were 74.6%, 87.5%, 90.4%, and 68.6%, respectively. The interclass correlation coefficients for inter-rater and test-retest reliability were 0.801 (&lt;i&gt;p&lt;/i&gt; = 0.011) and 0.828 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), respectively. The frequency of intermittent exotropia recorded by the app at home showed a strong positive correlation with other control scales (rho &gt; 0.770, &lt;i&gt;p&lt;/i&gt; = 0.009).Conclusions: This mobile phone app is easily accessible and useful for the rapid determination and recording of strabismus, particularly in uncooperative patients. Also, this app may be used as a reliable indicator of the frequency of manifest strabismus at home.

The Persian Version of the Mobile Application Rating Scale (MARS-Fa): Translation and Validation Study.

Approximately 110 million Farsi speakers worldwide have access to a growing mobile app market. Despite restrictions and international sanctions, Iran's internal mobile health app market is growing, especially for Android-based apps. However, there is a need for guidelines for developing health apps that meet international quality standards. There are also no tools in Farsi that assess health app quality. Developers and researchers who operate in Farsi could benefit from such quality assessment tools to improve their outputs. This study aims to translate and culturally adapt the Mobile Application Rating Scale in Farsi (MARS-Fa). This study also evaluates the validity and reliability of the newly developed MARS-Fa tool. We used a well-established method to translate and back translate the MARS-Fa tool with a group of Iranian and international experts in Health Information Technology and Psychology. The final translated version of the tool was tested on a sample of 92 apps addressing smartphone addiction. Two trained reviewers completed an independent assessment of each app in Farsi and English. We reported reliability and construct validity estimates for the objective scales (engagement, functionality, aesthetics, and information quality). Reliability was based on the evaluation of intraclass correlation coefficients, Cronbach α and Spearman-Brown split-half reliability indicators (for internal consistency), as well as Pearson correlations for test-retest reliability. Construct validity included convergent and discriminant validity (through item-total correlations within the objective scales) and concurrent validity using Pearson correlations between the objective and subjective scores. After completing the translation and cultural adaptation, the MARS-Fa tool was used to assess the selected apps for smartphone addiction. The MARS-Fa total scale showed good interrater reliability (intraclass correlation coefficient=0.83, 95% CI 0.74-0.89) and good internal consistency (Cronbach α=.84); Spearman-Brown split-half reliability for both raters was 0.79 to 0.93. The instrument showed excellent test-retest reliability (r=0.94). The correlations among the MARS-Fa subdomains and the total score were all significant and above r=0.40, suggesting good convergent and discriminant validity. The MARS-Fa was positively and significantly correlated with subjective quality (r=0.90, P<.001), and so were the objective subdomains of engagement (r=0.85, P<.001), information quality (r=0.80, P<.001), aesthetics (r=0.79, P<.001), and functionality (r=0.57, P<.001), indicating concurrent validity. The MARS-Fa is a reliable and valid instrument to assess mobile health apps. This instrument could be adopted by Farsi-speaking researchers and developers who want to evaluate the quality of mobile apps. While we tested the tool with a sample of apps addressing smartphone addiction, the MARS-Fa could assess other domains or issues since the Mobile App Rating Scale has been used to rate apps in different contexts and languages.

Cross-Cultural Validation of the Short Version of the Questionnaire of Olfactory Disorders-Negative Statements into Italian: Towards Personalized Patient Care.

Given the high burden of olfactory dysfunction worldwide, recently increased due to the COVID-19 pandemic, it is mandatory to adopt a specific questionnaire to assess the impact of olfactory impairment on quality of life, to be used in clinical practice. The aim of this study is to adapt and validate the short version of the Questionnaire of Olfactory Disorders-Negative Statements (svQOD-NS) for Italian. In the pilot phase, the Italian version of the questionnaire (ITA-svQOD-NS) was produced following recommended guidelines. It was then given to 50 healthy subjects and 50 patients (affected by either nasal polyposis or septal deviation), and results were compared to those of other widely used questionnaires. Test-retest reliability was assessed on a sample of 25 patients. All 50 patients repeated the questionnaires at one and nine months after surgery. The internal consistency of ITA-svQOD-NS measured with Cronbach α was excellent (α = 0.92). The intraclass correlation coefficient for test-retest reliability was also optimal (0.93; 95%CI: 0.90-0.96). Concurrent validity tested with the Pearson coefficient was significant with all other tests administered; also, concerning responsiveness, statistically significant differences were obtained between pre- and post-operative conditions. ITA-svQOD-NS showed high internal consistency, test-retest reliability, and significant correlation with all most-used clinical questionnaires; thus, it can be efficiently applied to assess olfaction-related QoL in the Italian population.

The validity and reliability of the Korean version of the General Attitudes towards Artificial Intelligence Scale for nursing students

Purpose: The aim of the study was to verify the validity and reliability of the Korean version of the General Attitudes towards Artificial Intelligence Scale (GAAIS-K) for nursing students.Methods: Data from 235 participants were collected from April 12 to April 26, 2022. A total of 230 participants’ data were analyzed. The data were analyzed for content, discriminant, known-groups, and construct validity using content validity index, correlation coefficient, and confirmatory factor analyses. The reliability of the GAAIS-K was examined using internal consistency and test-retest analyses.Results: The expert-rated content validity index was ≥.80. The sub-scales of the GAAIS-K were moderately correlated with attitude toward accepting technology, indicative of its discriminant validity. The male students’ positive attitude score was significantly higher than that of the female students, satisfying the known-groups validity. Cronbach’s α for the scale was .86 (positive) and .74 (negative), and the intra-class correlation coefficient for the two-week test-retest reliability was .86 (positive) and .60 (negative). The scores for positive and negative attitudes were 3.68±0.46 and 3.05±0.55.Conclusion: This study shows that the GAAIS-K is a valid and reliable instrument for assessing nursing students. Additional research is recommended to continue the evaluation of the GAAIS-K with a focus on healthcare settings.

Psychometric Evaluation of the Narrow Corridor Walk Test (NCWT) on Advanced Walking Balance in People with Stroke.

To investigate (i) the interrater and test-retest reliabilities of completion time and number of steps in the Narrow Corridor Walking Test (NCWT); (ii) the minimal detectable changes (MDCs) in NCWT results; (iii) the correlations between NCWT results and stroke-specific outcome measures; and (iv) the optimal cut-off values of NCWT results for discriminating the difference in advanced balance ability between people with stroke and healthy older adults. Cross-sectional. Thirty people with stroke and 30 healthy older adults. People with stroke completed the NCWT on two separate days with a 7- to 10-day interval. The Fugl-Meyer Assessment (FMA), ankle dorsiflexor and plantarflexor muscle strength, Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and the Chinese version of the Community Integration Measure (CIM) were used to assess. The healthy older adults completed the NCWT once. The NCWT completion time and NCWT steps showed excellent interrater reliability and test-retest reliability and significant correlations with FMA, affected ankle dorsiflexor muscle strength, BBS score, and TUG completion time. A cut-off value of 7.40 s for NCWT completion time and 13.33 for the NCWT steps distinguished people with stroke from healthy older adults. The MDCs of the NCWT completion time and NCWT steps were 6.87 s and 5.50, respectively. The NCWT is a reliable clinical measurement tool for the assessment of advanced balance ability in people with stroke.

What If You Can't Ask Them? Psychometric Properties of a Behavioral Assessment of Sibling Relationship Quality.

Building on studies of preferences for social interaction in children with autism spectrum disorder (ASD) we sought to provide a way for siblings with ASD to express their perspective about the quality of their sibling relationships. We developed a behavioral assessment of sibling relationship preference (Sibling Relationship Assessment [SRA]) and examined the psychometric properties of test-retest reliability, inter-rater reliability, and convergent validity. The SRA was feasible to administer and revealed expected differences between sibling dyads with one sibling with ASD compared to typically-developing sibling dyads. We found strong positive correlations for inter-rater reliability and test-retest reliability and convergent validity. The SRA provides a way to assess the perspective of the sibling with ASD that taps one characteristic, preference for spending time with one's sibling, of the quality of sibling relationships.

Turkish Translation, Validation, and Reliability Analysis of Pediatric Eosinophilic Esophagitis Symptom Severity Module Version 2.0.

The PEESv2.0 was translated into Turkish by standardized procedural steps completed in cooperation with the Mapi Research Trust. The final version of the questionnaire was submitted to eosinophilic oesophagitis patients or their parents at 2 times point separated by 1 week. An age-matched control group was used to test the discriminant validity. Construct validity was tested using the Wilcoxon test, and internal consistency was tested using Cronbach's alpha. Test-retest reliability was measured with Cohen's kappa and intraclass correlation coefficient. One hundred twenty-eight participants (70 patients, 58 parents) were enrolled. Fifty-eight (39.1%) of them completed T-PEESv2.0-parent by proxy and 70 (54.7%) were T-PEESv2.0. The Cronbach's alpha coefficient and intraclass correlation coefficient for test-retest reliability were >0.70 for both questionnaires and for all domain (frequency and severity) and total scores. For discriminant validity analysis, subscale (frequency and domain) and total scores of the patient group were compared with those of the control group. The subscale and total scores were significantly different between the groups (P < 0.05). T-PEESv2.0 appeared to be valid and reliable, ready to be introduced as a clinical and research tool for the assessment of patients with eosinophilic oesophagitis.

Development and preliminary validation of the Coach Self-Efficacy Body Image Scale (CSEBIS)

Body image concerns are a commonly cited reason for sport drop out. Researchers have begun to explore the influence of coaches on athletes’ body image. However, no measure exists to accurately and easily assess interventions or predict coaches’ body image supportive behaviors. Using Self-Efficacy Theory as a conceptual framework, the Coach Self-Efficacy Body Image Scale (CSEBIS) was developed. Content validity was judged by a panel of experts (N = 3) and through interviews with coaches (N = 4) across various sports and experience levels. Following initial item iteration, the CSEBIS was assessed with 682 coaches for reliability and validity. The 27 items across four subscales (knowledge, recognition, engagement, disengagement) showed good reliability (internal consistency, test-retest reliability, inter-item and item-total correlations), validity (convergent and discriminant validity, differentiation between known groups), factor structure, and model invariance across gender. Developing and initially validating the CSEBIS contributes to the existing literature by providing researchers with a novel scale to measure coaches’ confidence in identifying and addressing body image concerns among their athletes. Following further testing, this instrument may be used to assess the effectiveness of body image education and intervention efforts in sport, and the impact of coaches’ attitudes and behaviors on athletes’ body image.

A Chinese version of the revised Fibromyalgia Impact Questionnaire: A validation study.

The revised Fibromyalgia Impact Questionnaire (FIQR) was developed to measure the quality of life of patients with fibromyalgia in randomized controlled trials and routine care. The purpose of this study was to translate and adapt the FIQR from English to Chinese, and to examine the validity and reliability of the Chinese version of the FIQR (CFIQR). Following the translation of the FIQR, fibromyalgia patients from 6 centers were recruited and completed the CFIQR, the validated Chinese version of the Medical Outcome Study Short Form 36 Health Survey (SF-36) and the Beck Depression Inventory (BDI). In this study, Cronbach's alpha coefficient, test-retest reliability and item total correlation were used for evaluating external and internal reliability; and criterion and structural validity were evaluated. A total of 200 fibromyalgia patients completed the study. The internal consistency was excellent (Cronbach's alpha .90, .88, .88 and .93 for function, overall impact, symptoms scales and total score, respectively; item-total correlations from .25 to .83.) Test-retest reliability levels of the CFIQR total and subscale scores were strong correlation (intraclass correlation coefficient >0.75). Furthermore, there were significant correlations between the 3 subscale and the total score of the CFIQR and the SF-36, as well as the CFIQR and the BDI, by criterion validity (P < .01). Confirmatory factor analysis gave an acceptable value for structural validity according to the 3-factor structures of function, overall impact and symptoms. The CFIQR is a valid and reliable instrument for both clinical practice and research purposes with Chinese speakers globally. [ClinicalTrials.gov: NCT03381131].

Development and validation of a fall risk Questionnaire in Greek community-dwelling individuals over 60 years old

Objectives:The purpose of this study was to develop a questionnaire that can reliably recognize Greek individuals over the age of 60 with increased risk of falls.Methods:An 11-item self-reported Questionnaire (LRMS) was developed and delivered to 200 individuals. Collected data were compared to Timed Up and Go (TUG), Falls Efficacy Scale-International (FES-I), Tinetti Assessment Tool, Geriatric Depression Scale-15 (GDS-15) and Morse fall scale. The results were statistically analyzed.Results:Correlation between LRMS and the examined tools was high TUG (r=0.831), FES-I (r=–0.820), Tinetti balance (r=–0.812), Tinetti gait (r=–0.789), GDS-15 (r=–0.562), and Morse fall scale (r=0.795). Cronbach’s alpha for LRMS total score was 0.807. ICC of the LRMS total score was 0.991. The area under the curve of LRMS was 0.930 (cut-off point 10.5, 95% C.I. 0.88 - 0.98, p<0.001, sensitivity=86%, specificity=98%) with TUG as gold standard, 0.919 (cut-off point 11.5, 95% C.I. 0.88 - 0.96, p<0.001, sensitivity=85%, specificity=89%) with FES-I and 0.947 (cut-off point 10.5, 95% C.I. 0.91 - 0.98, p<0.001, sensitivity=93%, specificity=91%) with Tinetti.Conclusions:The LRMS Questionnaire showed sufficient internal consistency, excellent test–retest reliability and high correlation with the already established tools for fall risk assessment. It is short and easy to use without assistance from specially trained personnel.

Development of the Orthodontic Treatment Impact Questionnaire: Cross-sectional validation

The need to involve patients in developing and evaluating health care interventions is now well-recognized. This study assesses and refines the Orthodontic Treatment Impact Questionnaire for use as a patient-reported outcome in an interventional clinical trial to evaluate and compare any orthodontic interventions. The face and content validity of a previously developed questionnaire were tested in 2 focus groups involving adolescents aged 11-17 years. They were wearing a range of orthodontic appliances and at different treatment stages. A similar cross-sectional convenience sample completed the questionnaire during routine appliance adjustment appointments. A Rasch model, using item response theory, was used for item reduction, assessment of the response format, and differential item functioning. Spearman's rank correlation was used to assess construct validity, Cronbach α for internal consistency and reliability, and intraclass correlation coefficient for test-retest reliability. Seven adolescents (4 females, 3 males) were involved in the initial testing; 181 (117 females, 64 males; mean age, 14.7 ± 1.5 years) completed the questionnaire once and 41 twice. The initial measure demonstrated a misfit to the Rasch model. Ten of the original 31 items had disordered thresholds and were removed. The 5-point scale was changed to a 3-point scale. None of the participants demonstrated a misfit to the model. Construct validity (P= 0.480), internal consistency (Cronbach α= 0.827) and test-retest reliability (intraclass correlation coefficient= 0.85; 95% confidence interval, 0.73-0.92) were good. The initial Orthodontic Treatment Impact Questionnaire was tested and modified using item response theory. The modified questionnaire demonstrated good construct validity, reliability, and internal consistency. Further testing to assess generalizability and longitudinal responsiveness is required.

Further validation of the THINC-it tool and extension of the normative data set in a study of n=10.019 typical controls.

We report further validation and normative data for the THINC-Integrated Tool (THINC-it), a measure of cognitive function designed for use with individuals living with Major Depressive Disorder, but which is finding use in further psychiatric and neurological diseases. THINC-it comprises four objective computerised cognitive tests based on traditional psychological paradigms and a version of the Perceived Deficits Questionnaire assessment. Sample size of n=10.019 typical control study participants were tested on one to two occasions to further validate the reliability of THINC-it. Temporal reliability was assessed across 120-180days. Test-retest reliability correlations varied between r=0.50 and 0.72 for the component measures and r=0.75 (95% confidence intervals 0.74, 0.76) forthe THINC-it composite score. Normative data categorised by Age, Sex and Years of Education were calculated and the effect on task performance was reported. Our analysis confirms previously reported levels of reliability and validates previously reported normative data values.

Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review.

Cognitive impairment predisposes patients to the development of delirium and postoperative cognitive dysfunction. In particular, in older patients, the adverse sequelae of cognitive decline in the perioperative period may contribute to adverse outcomes after surgical procedures. Subtle signs of cognitive impairment are often not previously diagnosed. Therefore, the aim of this review is to describe the available cognitive screeners suitable for preoperative screening and their psychometric properties for identifying mild cognitive impairment, as preoperative workup may improve perioperative care for patients at risk for postoperative cognitive dysfunction. Electronic systematic and snowball searches of PubMed, PsycInfo, ClinicalKey, and ScienceDirect were conducted for the period 2015–2020. Major inclusion criteria for articles included those that discussed a screener that included the cognitive domain ‘memory’, that had a duration time of less than 15 min, and that reported sensitivity and specificity to detect mild cognitive impairment. Studies about informant-based screeners were excluded. We provided an overview of the characteristics of the cognitive screener, such as interrater and test-retest reliability correlations, sensitivity and specificity for mild cognitive impairment and cognitive impairment, and duration of the screener and cutoff points. Of the 4775 identified titles, 3222 were excluded from further analysis because they were published prior to 2015. One thousand four hundred and forty-eight titles did not fulfill the inclusion criteria. All abstracts of 52 studies on 45 screeners were examined of which 10 met the inclusion criteria. For these 10 screeners, a further snowball search was performed to obtain related studies, resulting in 20 articles. Screeners included in this review were the Mini-Cog, MoCA, O3DY, AD8, SAGE, SLUMS, TICS(-M), QMCI, MMSE2, and Mini-ACE. The sensitivity and specificity range to detect MCI in an older population is the highest for the MoCA, with a sensitivity range of 81–93% and a specificity range of 74–89%. The MoCA, with the highest combination of sensitivity and specificity, is a feasible and valid routine screening of pre-surgical cognitive function. This warrants further implementation and validation studies in surgical pathways with a large proportion of older patients.

Psychometric properties of the Chinese version of female self-advocacy in cancer survivorship scale

ObjectiveTo translate Female Self-Advocacy in Cancer Survivorship (FSACS) scale and evaluate the psychometric properties of Chinese version of FSACS scale among female cancer survivors in China. MethodsThis study employed a cross-sectional design. FSACS scale was forward–backward translated and cognitive interviews were conducted for cultural adaptation. The newly translated tool was distributed to female cancer survivors to test psychometric properties, including item analysis, content validity, construct validity, criterion validity, internal consistency, and test-retest reliability. ResultsA total of 436 female cancer survivors were recruited in a Chinese tertiary cancer center from May to August in 2021. Item analysis showed statistical significance (P < 0.05) for each one and no ceiling or floor effect. The item-level content validity index ranged from 0.86 to 1.00 and the scale-level content validity index was 0.98. Three factors were extracted based on parallel analysis, and confirmatory factor analysis proved a good model fit with the original 3-factor structure. Pearson's correlation coefficient showed acceptable criterion validity. The Cronbach's α of 0.880 demonstrated the scale's internal consistency reliability, and the Alpha coefficients were 0.826, 0.763, and 0.859 for its three dimensions, respectively. The interclass correlation coefficients for test-retest reliability was 0.904 (0.870–0.891, P < 0.01) which confirmed the external reliability of the scale. ConclusionsThe Chinese version of FSACS scale proved to be a valid and reliable instrument that can be applied among Chinese female cancer survivors. Further research could be conducted in larger populations or people in different cancer stages.

Modified Delphi in adapting a tool to assess the level of knowledge and practice on adult enteral nutrition therapy among nurses

Background: Enteral nutrition (EN) is the preferred method of nutritional administration for critically ill patients according to the world’s standards. Nurses have a key role in delivering EN and assessing nurses’ knowledge and practice on this, are crucial for maintaining quality nursing care. Aims and Objectives: This study was to utilize modified Delphi in adapting a tool to assess the level of knowledge and practice on adult EN therapy among nurses in Sri Lanka. Materials and Methods: A three-round modified Delphi technique (DT) was employed in adapting a research tool to assess nurses’ knowledge and practice according to the nursing and EN guidelines in Sri Lanka. The questionnaire included 34 knowledge assessment items and 41 observational items to assess practice. Eight subject experts were purposively selected to rate each item on a 5-point Likert scale under three subheadings. Consensus defined at 80% agreement and mean ≥3. Mean value &lt;3 was considered for suggested modifications. Experts participated in a final meeting in round 3 to finalize the tool. Results: Response rate was 100% throughout the process. During round 1, 13/34 knowledge items were modified, two were removed, and one item was added. In round 2, four items were modified, and one was removed. From the observational items, 40/41 achieved consensus, one was modified, and a new one was added in round one. One was modified in round 2. All achieved consensus by round three. The final tool contained 32 knowledge items and 42 observational items with test-retest reliability correlations ranging from 0.99 to 0.95. Conclusion: Modified DT was appropriate in achieving judgmental validity through experts’ consensus in adapting a research tool to assess nurses’ knowledge and practices on EN therapy for adult critically ill patients in Sri Lanka.

Validity Evidence of the eHealth Literacy Questionnaire (eHLQ) Part 2: Mixed Methods Approach to Evaluate Test Content, Response Process, and Internal Structure in the Australian Community Health Setting.

BackgroundDigital technologies have changed how we manage our health, and eHealth literacy is needed to engage with health technologies. Any eHealth strategy would be ineffective if users’ eHealth literacy needs are not addressed. A robust measure of eHealth literacy is essential for understanding these needs. On the basis of the eHealth Literacy Framework, which identified 7 dimensions of eHealth literacy, the eHealth Literacy Questionnaire (eHLQ) was developed. The tool has demonstrated robust psychometric properties in the Danish setting, but validity testing should be an ongoing and accumulative process.ObjectiveThis study aims to evaluate validity evidence based on test content, response process, and internal structure of the eHLQ in the Australian community health setting.MethodsA mixed methods approach was used with cognitive interviewing conducted to examine evidence on test content and response process, whereas a cross-sectional survey was undertaken for evidence on internal structure. Data were collected at 3 diverse community health sites in Victoria, Australia. Psychometric testing included both the classical test theory and item response theory approaches. Methods included Bayesian structural equation modeling for confirmatory factor analysis, internal consistency and test-retest for reliability, and the Bayesian multiple-indicators, multiple-causes model for testing of differential item functioning.ResultsCognitive interviewing identified only 1 confusing term, which was clarified. All items were easy to read and understood as intended. A total of 525 questionnaires were included for psychometric analysis. All scales were homogenous with composite scale reliability ranging from 0.73 to 0.90. The intraclass correlation coefficient for test-retest reliability for the 7 scales ranged from 0.72 to 0.95. A 7-factor Bayesian structural equation modeling using small variance priors for cross-loadings and residual covariances was fitted to the data, and the model of interest produced a satisfactory fit (posterior productive P=.49, 95% CI for the difference between observed and replicated chi-square values −101.40 to 108.83, prior-posterior productive P=.92). All items loaded on the relevant factor, with loadings ranging from 0.36 to 0.94. No significant cross-loading was found. There was no evidence of differential item functioning for administration format, site area, and health setting. However, discriminant validity was not well established for scales 1, 3, 5, 6, and 7. Item response theory analysis found that all items provided precise information at different trait levels, except for 1 item. All items demonstrated different sensitivity to different trait levels and represented a range of difficulty levels.ConclusionsThe evidence suggests that the eHLQ is a tool with robust psychometric properties and further investigation of discriminant validity is recommended. It is ready to be used to identify eHealth literacy strengths and challenges and assist the development of digital health interventions to ensure that people with limited digital access and skills are not left behind.

Kinematic evaluation and reliability assessment of the Nine Hole Peg Test for manual dexterity

BackgroundThe Nine Hole Peg Test (NHPT) is one of the most frequently used tools to assess manual dexterity. However, no kinematic parameters are provided to describe the quality of the motor performance, since time is the only score. PurposeTo investigate test-retest and intra-rater reliability, correlation with clinical test score, and discriminant validity of kinematic indexes during NHPT. Study DesignA clinical measurement study. MethodsTwenty-five healthy right-handed volunteers performed the NHPT. An experienced physiotherapist administered two sessions at a 6-hour interval with two trials for dominant and non-dominant upper limbs. An optoelectronic system was used to detect NHPT performance, which was divided into nine consecutive peg-grasp, peg-transfer, peg-in-hole, hand-return phases, and one final removing phase. Outcome measures were total and single phases times, normalized jerk, mean, peak and time-to-peak of velocity, curvature index during peg-grasp and hand-return phases, and trunk 3D displacement. The statistical analysis included Intraclass Correlation Coefficients (ICCs) for test-retest and intra-rater reliability, Pearson's coefficients for correlation with the NHPT score, and paired t-tests for discriminant validity. ResultsTest-retest reliability was excellent for trunk rotation (ICC: 0.91) and good to moderate for the other indexes (ICCs: 0.89-0.61). Intra-rater reliability was excellent for total and removing times (ICCs: 0.91 and 0.94) and good to moderate for the other indexes (ICCs: 0.84-0.66), except for trunk inclination (ICC: 0.37). NHPT phases, normalized jerk, mean velocity, peak of velocity, time-to-peak and curvature index correlated with total time (r-score: 0.8-0.3). NHPT phases and most kinematic indexes discriminated the dominant from non-dominant upper limb, with the greatest effect size for normalized jerk during hand-return (d = 1.16). ConclusionsKinematic indexes during NHPT can be considered for manual dexterity assessment. These indexes may allow for the detection of kinematic changes responsible for NHPT score variations in healthy subjects or patients with upper limb impairments.

DEVELOPING TWO-TIER DIAGNOSTIC INSTRUMENT TO DETERMINE MISCONCEPTIONS ON SOCIOSCIENTIFIC ISSUES

Socioscientific issues, which we encounter more and more frequently, will gain much more importance in the coming years. Socioscientific issues have many topics that individuals will experience decision-making processes in the future. Adequate knowledge of the concepts lies at the basis of the decision-making process. The aim of this study is to develop a two-tier diagnostic test to identify misconceptions in socioscientific issues and to study the validity and reliability of this test. In this scale, which was developed in the mixed method, there are questions about energy resources, global warming, genetic engineering and cloning. In order to develop the two-tier test, a process consisting of three basic stages was carried out: determining the content, obtaining information about students' misunderstandings, and developing the diagnostic test. The data of the study were collected from eighth and ninth grade students. In order to determine the final version of the scale; the reliability, difficulty and discrimination values were analyzed with the data of 385 students. A test-retest application was also made with the participation of 55 students. The KR-20 value of the 30-item two-tier socioscientific issues concept test developed is 0.85, the average difficulty value is 0.46987, the average discrimination value is 0.497364, and the Pearson Correlation coefficient for test-retest reliability was 0.776. As a result of the study, a valid and reliable two-tier diagnostic test consisting of 30 items that can be used to identify misconceptions in socioscientific issues has been developed