Cronbach's Alpha Research Articles

Evaluating anxiety and self-confidence in nursing students: Adaptation and validation of the NASC-CDM scale for high-fidelity simulation training

BackgroundAnxiety and self-confidence impact performance and decision-making during high-fidelity simulation in nursing education. A validated tool to assess these factors is lacking. MethodsThe Nursing Anxiety and Self-Confidence with Clinical Decision-Making© scale (NASC-CDM) was translated, adapted for high-fidelity simulation and validated using a five-step approach. This included a Content Validity Index review by experts and pilot-testing with first-year nursing students. Construct validity and internal consistency were evaluated using Exploratory Factor Analysis and Cronbach's alpha. ResultsA total of 187 first-year nursing students participated. Exploratory Factor Analysis identified constructs for anxiety (two factors, 60.72% variance) and self-confidence (three factors, 61.22% variance). The tool demonstrated high internal consistency, with Cronbach's alpha values of 0.956 for anxiety and 0.955 for self-confidence. ConclusionThe 19-item Dutch Nursing Anxiety and Self-Confidence with Clinical Decision-Making for High-Fidelity Simulation scale is a valid and reliable instrument measuring anxiety and self-confidence in nursing students during high-fidelity simulation.

Cross-cultural adaptation and validation of a revised Italian Anterior Knee Pain Scale version.

The study aimed to validate a revised Italian version of the Anterior Knee Pain Scale (AKPS) by addressing shortcomings in previous adaptations and following the COSMIN guidelines to ensure robust psychometric evaluation. One hundred thirty patients with anterior knee pain symptoms were recruited, with 65 undergoing a retest after 7 days to assess the scale's reliability. Structural validity was assessed through confirmatory factor analysis (CFA) to evaluate the scale's dimensionality. Internal consistency was measured using Cronbach's alpha, while test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Measurement error was evaluated using the standard error of measurement (SEM) and the smallest detectable change (SDC). Construct validity was examined by correlating the AKPS with other established scales, including the Knee Injury and Osteoarthritis Outcome Score, Internal Knee Documentation Committee, Victorian Institute of Sport Assessment - Patella, Short-Form 36 Health Survey, and the Visual Analogue Scale. The CFA supported a three-factor model encompassing pain intensity and interference, functional limitations in daily activities, and knee structural and functional issues. The scale demonstrated good internal consistency (Cronbach's α=0.79) and excellent test-retest reliability (ICC=0.91), with low measurement error (SEM<5%). Construct validity was confirmed through moderate-to-strong correlations with related scales, particularly in domains related to pain intensity, symptoms, and daily functioning. The newly validated scale, demonstrating strong psychometric properties, meets international standards for clinical assessment tools, making it a reliable and effective instrument for assessing anterior knee pain in the Italian context.

Analysis of Factors Affecting the Effectiveness of Road Maintenance in Pidie Regency

Land transportation infrastructure as a medium of accessibility for various community needs that have an important role in economic growth, socio-cultural, political, and other factors of a region or area. In order for road infrastructure to function optimally in improving these factors, several important aspects need to be considered, including having user safety and comfort, environmentally friendly. Land transportation infrastructure is not only a means of mobility but also a tool to achieve better social and economic welfare for the entire community. Given the strategic role of land transportation infrastructure, namely roads, it is very necessary to have security and comfort values so that the efficiency and effectiveness of the infrastructure are indicators to be evaluated. The effectiveness and efficiency of roads are greatly influenced by many factors including road conditions and age, land use, social, economic and policy. community and related parties. The purpose of this study is to analyze the dominant factors that influence the effectiveness of road maintenance in Pidie district. This study uses a qualitative approach to analyze data obtained from respondents which are primary data and the use of SPSS as an analysis tool so that it becomes numerical. The results obtained for the instrument items used are reliable and trustworthy, this is based on the Cronbach's Alpha (CA) value obtained in the range of 0.50 to 0.70. Based on the results and discussions obtained, it can be concluded that all proposed instrument items provide a significant contribution to determining the effectiveness of road maintenance decisions in Pidie Regency with the highest influence instrument factors being economic instruments and road conditions. The coefficient value obtained for the two factors is 5.571 for the economic instrument and followed in second place, namely the road condition instrument item with a coefficient of 3.603.

Resilient Coping Levels and Psychometric Properties of the Brief Resilient Coping Scale Among Nursing Professionals in Saudi Arabia.

This cross-sectional survey assessed resilient coping levels and their relationship with the sociodemographic characteristics of nursing professionals in Saudi Arabia. Adult (≥18 years) registered nurses who had been practicing for ≥1 year were included in the study. Resilient coping levels (as assessed via a 4-item Brief Resilience Coping Scale; BRCS) and the data of sociodemographic and other characteristics were collected. Descriptive analysis and ordinal logistic regression were used to analyze the data. Furthermore, the psychometric properties of the BRCS are also reported. Overall, 216 nursing professionals were included. The mean BRCS score was 14.6 (standard deviation = 3.6), with most nursing professionals (62.5%) reporting medium-to-high resilience coping levels. The ordinal logistic regression model demonstrated that nurses with increasing age (p = 0.002), best overall health (p = 0.001), and in the outpatient department (p = 0.049) and intensive care unit (p = 0.032) had significantly high resilient coping levels. The internal consistency of the BRCS was good (Cronbach's alpha = 0.80). The results of the exploratory factor analysis and confirmatory factor analysis clearly indicate a unidimensional solution with one factor. In summary, most nursing professionals in Saudi Arabia showed medium-to-high resilience coping levels. Moreover, this study suggests that the BRCS was found to be a psychometrically reliable and adequate tool for assessing resilience coping levels and provides valuable insights into the relationship between resilient coping levels and the sociodemographic characteristics of nursing professionals in Saudi Arabia.

Brazilian Portuguese version of questionnaires assessing evidence-based practice competencies in healthcare students: Translation, cross-cultural adaptation, and measurement properties

BackgroundWhile several instruments assess evidence-based practice (EBP) competencies, few are available for the Brazilian population, particularly healthcare students. ObjectiveTo perform a cross-cultural translation of the Student Evidence-Based Practice Questionnaire (S-EBPQ) and Evidence-Based Practice Evaluation Competence Questionnaire (EBP-COQ) into Brazilian Portuguese; to adapt and validate the Brazilian Portuguese versions for use with healthcare students from diverse courses; and to assess the measurement properties of the translated and adapted versions. MethodsFour hundred forty-two healthcare students were included, and three versions were tested: S-EBPQ-BR, EBP-COQ-BR for nursing students, and EBP-COQ-BR for healthcare students. We assessed internal consistency, reliability, construct validity, responsiveness, and ceiling/floor effects. For reliability, participants completed the questionnaires twice, one week apart. For responsiveness, they completed them after participating in an educational program. ResultsNo issues were identified with understanding or applicability. For overall scores, the translated questionnaires demonstrated strong internal consistency (Cronbach's alpha=0.87-0.92), good to moderate reliability (ICC3,1=0.63-0.88), construct validity with moderate to very strong correlations to the Evidence-Based Practice Questionnaire (r=0.43-0.89), no ceiling or floor effects, and adequate responsiveness with significant pre- and post-educational program score differences. For subscales, the majority of them demonstrated satisfactory measurement properties, except for S-EBPQ-BR attitude (low internal consistency, poor reliability, and ceiling effect), EBP-COQ attitude (inadequate construct validity), and EBP-COQ skills (inadequate construct validity). ConclusionThe Brazilian Portuguese versions of S-EBPQ and EBP-COQ exhibit strong measurement properties, including high internal consistency, adequate reliability, valid construct validity, and responsiveness. However, some subscales present suboptimal internal consistency, reliability, and construct validity.

Persian version of the McHale co‐parenting scale: The evaluation of the psychometric properties

AbstractValidation of the MacHale Co‐parenting Scale (1997) was examined in a sample of 192 Persian‐speaking parents who had children in primary school. Translation of this scale was performed using the forward–backward method. To assess reliability, internal consistency was used after translating the items into Persian. Face validity, content validity and structural validity were also applied to ensure tool validity. The results indicated that Ballit's sphericity test yielded a value of 1153.138 at a significance level of p &lt; .05. Using varimax rotation, three factors (Family Integrity, Consistency and Conflict) were identified with eigenvalues greater than 1 and factor loadings higher than 0.5. The total factors explained 58.18 per cent of the variance in the data. Additionally, the Cronbach's alpha coefficient for the entire questionnaire was 0.84. The Persian version of the co‐parenting questionnaire has satisfactory psychometric properties with acceptable reliability and validity for measuring joint parenting among Iranian parents in terms of family integrity, consistency and conflict dimensions.

Effect of Institutional Resources on Student Academic Achievement in Kakamega County, Kenya

The school environment has a substantial impact on the quality of education. A well-resourced, supportive, and positive environment can result in enhanced student outcomes, both academically and personally. This study sought to investigate the effect of institutional resources on student academic achievement Kakamega County, Kenya. The research employed the production function theory. The study was conducted using a descriptive correlational research design. This study took place in Kakamega County, which has thirteen sub-counties. The study focused on 423 secondary schools, which included 2 national schools, 2 national special schools, 28 extra county schools, 45 county schools, and 346 sub county schools. The target population included 423 Principals, 5514 teachers, and 182,893 learners, for a total of 188,830 respondents in Kakamega County secondary schools. Purposive sampling was used to choose special and national schools. The Yamane formula was used to determine a sample of 440 respondents. The study gathered data through interviews and questionnaires. A pilot study was conducted in Bungoma County to test the instruments' validity and reliability. Cronbach's alpha was employed as a statistical tool to assess reliability. The study analyzed quantitative data using Regression analysis. Qualitative data was analysed thematically. The results indicated that most of the institutions have resources that included classrooms, laboratories, libraries and others however they were not adequate. The results further revealed that most of the schools have adequate number of teachers while a sizeable were still struggling with fewer teachers. On the study’s hypothesis, H01 that states that there is no statistically significant effect of institutional resources on student academic achievement in Kakamega County, Kenya was rejected at p=0.003. The study concluded that there is a significant positive relationship between institutional resources and student academic achievement in Kakamega County, Kenya. The study thus recommends that the Ministry of Education and other stakeholders to enhance funding for school infrastructure, learning materials, and teacher training to improve student achievement. Implement strategies to boost student achievement and optimize teacher-student ratios like recruiting more teachers and teacher interns to fill the gaps.

Lung Cancer Screening Health Belief Model: Psychometric Properties of the Arabic Version and Factors Influencing Screening and Prevention Among Jordanians.

Several screening models have recently been applied to study awareness and help people make informed decisions regarding cancer screening. This study aimed to explore the knowledge, attitudes, and lung cancer screening health beliefs (LCSHBs) among Jordanians. Moreover, we intended to translate the LCSHBs scale into the Arabic language and test its validity and reliability. An online survey (Google Forms) was completed by 916 participants in Jordan via snowball sampling technique from February 10, 2024, to March 2, 2024, assessing lung cancer screening knowledge, lung cancer preventive attitudes, screening-related health beliefs, and stages of screening adoption. Linear regression analysis, correlations, and non-parametric statistics were utilized for statistical inference. Participants had high mean percentage scores of 86.56% and 85.75% for knowledge and preventive attitudes towards lung cancer screening, respectively. The Arabic version of the LCSHBs model was found to be a valid and reliable tool, as indicated by principal component analysis extraction and Cronbach's alpha values. Lung cancer screening knowledge was positively associated with perceived benefits and negatively associated with perceived barriers to screening. Knowledge, perceived barriers, perceived risk of lung cancer, self-efficacy (SE) to screen, and lung cancer preventive attitudes were significantly associated with the perceived benefits of lung cancer screening (p<0.05). We also found that the higher the SE, the higher the physical activity and the lower the perceived barriers. The Arabic version of the LCSHBs model is valid and reliable for assessing health beliefs toward lung cancer screening. We recommend enhancing targeted interventions, educational outreach, and improving health insurance access to reduce lung cancer incidence in Jordan and promote screening behaviors.

Measurement and Comparison of Different Dimensions of Renewable Energy Policy Implementation in the Agricultural Sector

The current research aims to measure the different dimensions of renewable energy policy implementation and compare these dimensions with each other, focusing on Iran's agricultural sector. This analysis makes it possible to identify the strengths and weaknesses in implementing existing policies. The five dimensions include "organizational and institutional", "incentives", "investment", "infrastructure", and "human resources development". The statistical population of this research comprised energy policy experts, whose number was 85. The sampling method was random, and 70 persons participated in answering the questionnaire using the Karjesi and Morgan table. A questionnaire was used to collect data. The reliability of the questionnaire was calculated using Cronbach's alpha (0.916). Face validity, content validity ratio (CVR), and content validity index (CVI) were applied to determine validity. In the calculation of CVR, values ≥0.33 were considered reasonable and appropriate to confirm each item. All CVI values obtained were higher than 0.79. Multi-criteria analysis was used to analyze the data. The results indicated that organizational and institutional policies were at the highest level of unsustainability. The dimension of investment policies showed less unsustainability than other dimensions. The other three dimensions also showed significant deficiencies. It seems that policy development to eliminate the diversity and interference of organizations, fuel subsidies revision, market policy development, attracting capital, and participation of stakeholders is necessary to reduce unsustainability in this field. The development of the resources of expert forces and attention to educational policies should also be considered.

Factors influencing job satisfaction among academic and nonacademic staff: The case of SIMAD University

A gap in empirical research has been identified regarding job satisfaction in Somalia's higher education sector, specifically at SIMAD University. To address this gap, this study aims to evaluate job satisfaction among both academic and nonacademic staff at the university. Data were collected from SIMAD University staff using purposive sampling, with 208 participants completing a structured questionnaire. The analysis was conducted using descriptive statistics and correlation analysis to assess job satisfaction levels, and Cronbach's alpha was used to test the reliability of the data. The findings show that, overall, staff have a high level of job satisfaction, though they expressed lower satisfaction in two areas: appointment and promotion processes and the physical work environment (organizational conditions). Additionally, all factors were positively correlated with job satisfaction. This study highlights areas where employee satisfaction could be improved, especially in the areas of promotions and the physical environment, and discusses the implications of these findings for university management.

Translation, Reliability and Development of a Calculator for the Brazilian Portuguese Version of the Family Empowerment Scale (FES) in Caregivers of Individuals With Cerebral Palsy.

Care for patients with cerebral palsy (CP) poses significant challenges, with emphasis on the crucial role of family involvement in patients' well-being. The Family Empowerment Scale (FES) assesses parents/caregivers' perception of their ability to promote and influence their children's development in three domains: family, service system and community. The objectives of this study were to translate the FES into Brazilian Portuguese, to develop a calculator for data transformation and analysis and to evaluate the psychometric properties of the scale with Brazilian caregivers of children and adolescents with CP. Translation occurred in four stages: translation, synthesis, back-translation and review of the translated version. A calculator was then developed in the Excel program, to present data in absolute values and graphically for each subscale. Statistical analysis included Bland-Altman, Intraclass Correlation Coefficient (ICC), Internal Consistency, and Floor and Ceiling Effect. In total, 50 parents and caregivers participated to the measurement properties investigation, and the scale demonstrated good reliability for the family (ICC = 0.80) and services (ICC = 0.81) subscales, as well as for the overall scale (ICC = 0.88). The community subscale showed moderate reliability (ICC = 0.68), with an adequate Cronbach's alpha (0.89). The FES showed no ceiling or floor effects and a small limit of agreement. The data of all participants were analysed using the calculator. The FES-Brazilian Portuguese presented good reliability for assessing family empowerment in caregivers of children and adolescents with CP in Brazil, offering insights into this construct and guiding family-centred interventions. In addition, the calculator could be viable for adequate management and dissemination of data.

Slovenian Translation, Cross-Cultural Adaptation, and Content Validation of the Updated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2).

The updated Oslo Sports Trauma Research Questionnaire on Health Problems (OSTRC-H2) has been translated into a limited set of languages and lacks full validation of its new measures. To (1) translate, cross-culturally adapt, and evaluate the measurement properties of the OSTRC-H2 for the Slovenian population and (2) investigate the construct validity for the severity score and time lost due to a health problem. Cohort study (diagnosis); Level of evidence, 3. The OSTRC-H2 was translated from English to Slovenian (OSTRC-H2-SLO) according to international guidelines. A 15-week study was conducted among 188 elite athletes, with a test-retest performed in the 10th week. Internal consistency, reliability, content validity, feasibility, and potential ceiling effects were investigated. Internal consistency was measured using the Cronbach alpha coefficient, while reliability was measured with the intraclass correlation coefficient (ICC). Construct validity was measured with the Spearman rank correlation coefficient (r S). There was a 95% response rate and an 18% mean weekly prevalence of health problems. The OSTRC-H2-SLO showed excellent test-retest reliability (ICC, 0.94 [95% CI, 0.67-0.99]), with a Cronbach α of .93. A strong positive correlation was found between the OSTRC-H2-SLO severity score and days lost due to an acute injury (r S = 0.754), overuse injury (r S = 0.785), and illness (r S = 0.894) (P < .001 for all). Moderate to strong negative correlations were observed between severity score and total load (training and competition load in hours) as well as between days lost and total load (P < .001 for all). The OSTRC-H2-SLO was found to be valid, reliable, and well accepted among Slovenian athletes. The authors confirmed the questionnaire's construct validity and identified total load as an indicator of an increase in the severity score. NCT05471297 (ClinicalTrials.gov identifier).

TURKISH VALIDITY AND RELIABILITY STUDY OF THE SUSTAINABILITY ATTITUDES IN NURSING SURVEY 2

PurposeIt is important to examine the attitudes of future nurses towards adopting a sustainability approach in their nursing practice. This study aimed to test the Sustainability Attitudes in Nursing Survey 2 psychometrically. MethodsThe methodological, descriptive study was conducted in November 2019 on nursing students (n = 286) at a university in Turkey. Data were analysed for reliability and validity tests. Statistics of the linguistic content validity analysis and Exploratory/ Confirmatory Factor Analysis were performed to determine the scale's validity. Cronbach Alpha coefficient, floor and ceiling impacts, Tukey’s test, and Hotelling’s T2 test, test-retest reliability, were determined for the scale's reliability. ResultsThe content validity index of the scale, which consists of five items and a one dimension, is .98. Factor loadings were above 0.30, all the fit indices were> 0.95, χ2/df was 1.58 and the root means square error of approximation was 0.045. Cronbach's α was .75. The floor and ceiling impacts were 0.0% and 3.1%. In Tukey’s test, F was 3.43 and p was 0.064. In Hotelling’s T2 test, Hotelling’s T2 was 265.59 and F was 65.68 (p < .001). Item-total correlation coefficients were between .37- .63. The test-retest correlation coefficient was .39. ConclusionsThe scale is a valid and reliable instrument in the Turkish language. It is advised to use the scale in determining attitudes towards sustainability among nursing students, evaluating the effectiveness of training, and taking student opinions in curriculum revisions. Also, the study allowed cross-country comparisons and it is thought that it can guide studies on the inclusion of sustainability principles in nursing practices.

Metacognitive reading strategies: gender, locality, and age differences among secondary school students

This study ascertained the influence of gender, locality and age on metacognitive reading strategies of secondary school students. The sample size consists of 440 students randomly selected from 23 secondary schools. An adopted questionnaire tagged “metacognitive reading strategies questionnaire,” was used as the data gathering instrument, with a logical validity of 0.88 and Cronbach alpha of 0.73 as internal consistency. The data collected were analysed statistically using descriptive statistics and t-tests. Data analysis revealed that females' reading strategies outnumber males'; females' global strategies ranked highest, while females' problem-solving strategies ranked lowest; and students in urban secondary schools tended to utilise metacognitive reading strategies more frequently than their rural counterparts. This study also shows that students with higher age brackets make more use of metacognitive reading strategies than lower-age students. Therefore, it is recommended that educators should be prepared to educate students how to effectively utilise various components of metacognitive reading strategies.

Validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale.

Stigma against people who have alcohol and drug problems severely affects their health and well-being. An instrument based on stigma theory assessing individual-level stigma is essential for a comprehensive understanding of their stigma. We evaluated the validity and reliability of the Japanese version of the Substance Use Stigma Mechanism Scale (SU-SMS-J) among a population who had alcohol or drug use problems. Adults with experience in substance use disorders from psychiatry outpatient departments and rehabilitation facilities participated in the self-administered questionnaire survey. Confirmatory factor analysis was conducted to test the structural validity of the 5-factor model proposed in other language versions, and factor loadings and correlation between the subscales were confirmed. The correlations between the SU-SMS-J and psychometric properties related to substance use (e.g., severity of substance use, motivation to change) were investigated to assess concurrent validity. Internal consistency was assessed using Cronbach's alpha coefficients. Data from 126 participants were analyzed. The 5-factor model was acceptable with good or reasonable model fit indices. The correlations between subscales were weak to moderate, and this result suggested the SU-SMS-J assessed different but related components of stigma: enacted, anticipated, and internalized stigma from different stigma sources (family and healthcare workers). The SU-SMS-J and subscales showed moderate concurrent validity. Internal consistency was mostly sufficient, with Cronbach's alpha coefficients of 0.86 for all items and 0.66-0.93 for subscales. The SU-SMS-J is valid and reliable for use among populations with substance use problems in various settings in Japan.

Development of Essential Thinking Test Instrument using the Presseisen Taxonomy on Ecosystem Material for Grade X High School Students

The test instrument is a measuring tool in the assessment process used to obtain information in the form of data on student learning outcomes, both cognitive aspects and thinking skills. The use of test instrument to measure students' thinking skills is still rarely used. This study aims to develop an essential thinking test instrument using the Presseisen taxonomy on valid and reliable ecosystem material. This research uses the Research Development (RD) method with the 3D modified development model combined with the test development stages consisting of 6 stages. Data collection in this research was carried with interviews, tests, and test instrument validation sheets. The analysis included content validity analysis, interrater reliability, and Rasch model analysis. The results showed that all items were valid based on content validity. Interrater reliability has a value of 0.783 with a good category. All items are declared fit, but item number 7 contains bias so it needs to be discarded. Cronbach's alpha has a value of 0.68 in the enough category, person reliability has a value of 0.50 in the weak category, and item reliability has a value of 0.99 in the excellent category. The item difficulty level group consists of 2 very difficult questions, 4 difficult questions, 2 easy questions, and 2 very easy questions. Based on the result of the research, it can be concluded that there are 9 items that are declared valid and reliable for use.

Selection of a classroom observation tool for disability inclusion in Uganda.

Obuntu Bulamu is a Ugandan intervention promoting inclusive education for children with disabilities. This culturally appropriate approach, based on the Ubuntu philosophy, utilises peer-to-peer support activities for children, parents and teachers. To effectively measure the intervention's impact on disability inclusion, the study aimed to select, adapt and test classroom observation instruments suitable for the Ugandan context. Three structured classroom observation tools were selected and piloted in 10 primary schools in Wakiso District: The Classroom Observation Checklist (CoC), the Teacher-Pupil Observation Tool (T-POT) and the Interaction Engagement Scale (IES). These tools were adapted to ensure cultural relevance and applicability within Ugandan school settings. Factors like class size, teaching methods, cultural relevance, language and ease of use influenced the suitability of the selected tool. The CoC emerged as a more effective tool with a strong internal consistency (Cronbach's alpha of 0.80) for capturing inclusiveness and peer-to-peer support in the classroom compared to the T-POT and IES. The study findings emphasise the significance of adapting and testing tools in specific cultural contexts and low-income country settings and considering culturally contextual factors like class size, teaching methods, language complexity and ease of use when measuring disability inclusion in primary schools. The selection of a classroom observation tool for the Obuntu Bulamu randomised control trial contributed to African disability knowledge and practices designed on and for the continent.

The Influence of E-Commerce Innovation and E-Services Quality on Customer loyalty with Customer Satisfaction as Mediator in Gen-Z

This study investigates the influence of e-commerce innovation and e-service quality on customer satisfaction and loyalty among Gen-Z students in Surabaya. Utilizing a non-probability sampling technique and the Lameshow formula, data were gathered via a structured questionnaire from 384 active students aged 20-25 years. Multiple linear regression analysis, conducted with the PLS program, revealed that all variables met the validity (AVE &gt; 0.05) and reliability (Cronbach's alpha &gt; 0.7) criteria. The hypothesis tests indicated that e-commerce innovation does not significantly affect customer loyalty (P-value 0.976 &gt; 0.05), whereas e-service quality does (P-value 0.000 &lt; 0.05). Both e- commerce innovation and e-service quality significantly impact customer satisfaction (P-value 0.000 &lt; 0.05), which, in turn, significantly influences customer loyalty (P-value 0.000 &lt; 0.05). Additionally, the study found that e- commerce innovation and e-service quality significantly affect customer loyalty when mediated by customer satisfaction (P-value 0.000 &lt; 0.05).

Cross Cultural Validation of Oral Health Index Profile for Temporomandibular Disorders in Spanish Speaking Population.

Structured patient-centred assessment is critical for improving care. OHIP-TMDs are a validated English-language outcome measure for temporomandibular disorders (TMD) which evaluates the biopsychosocial impact of TMD. Due to language and cultural changes, the original instrument's phrasing of its items may change when translated to Spanish. This study cross-culturally adapted and validated OHIP-TMDs for Spanish-speaking individuals with TMD. OHIP-TMDs was forward-backward translated into Spanish (OHIP-TMDs-Sp) and cross-culturally adapted to a Hispanic population with TMD (Diagnostic Criteria for TMD n = 154) according to international norms. All patients completed the OHIP-TMDs-Sp, the Graded Chronic Pain Scale (GCPS), and Jaw Functional Limitation Scale (JFLS-20). A subsample (n = 30) recompleted the OHIP-TMDs-Sp after a 3-week washout to measure test-retest reliability using an intra-class correlation coefficient (ICC 2.1). OHIP-TMDs-Sp, JFLS-20, and GCPS were analysed for convergent validity and internal consistency. The sample with articular and muscular TMD diagnoses was 85.7% female with a mean age of 29.5. (SD 9.01). OHIP-TMDs-Sp had high internal reliability (Cronbach's Alpha = 0.95) and good test-retest reliability (ICC = 0.82; 95% CI = 0.57-0.93). In terms of convergent validity, the OHIP-TMDs-Sp demonstrated moderate to large positive correlations with the total JLFS-20 score (ρ = 0.72; p < 0.01), Mastication (ρ = 0.68; p < 0.01), Communication (ρ = 0.68; p < 0.001), as well to GCPS disability score (ρ = 0.59; p < 0.01), and characteristic pain intensity (ρ = 0.69; p < 0.01). The total score of OHIP-TMDs-Sp is reliable for assessing quality-of-life in Spanish-speaking TMD patients.

Psychometric Properties of the Generalized Anxiety Disorder Scale (GAD-7) in Older Adults With Advanced Cancer.

Over half of new cancer diagnoses occur in patients aged 65 or older, with up to 40% experiencing anxiety. The American Society of Clinical Oncology recommends using the Generalized Anxiety Disorder Scale (GAD-7) for anxiety screening, but the GAD-7 psychometric properties in this population are unknown. This study examined the GAD-7's reliability, validity, and item parameters, comparing its utility with the GAD-2 in older adults with cancer. This cross-sectional secondary analysis of a nationwide multi-site two-arm cluster randomized trial in older adults (≥70)with advanced cancer. The GAD-7 was administered at baseline. Properties were evaluated with Cronbach's α, Pearson correlation coefficients, and a 2-parameter logistic model. Logistic regression models compared the GAD-2 and GAD-7. The sample included 718 participants (Mean age=77, SD=5) with mild anxiety (M=3.74, SD=4.74). Internal consistency was strong (Cronbach's alpha=0.89) and item-total correlations ranged 0.53 to 0.78. Item 2 (Not being able to stop or control worrying) was the most discriminating and item 5 (Being so restless that it is hard to sit still) was least discriminating. Area Under the Curve (AUC) analyses demonstrated the GAD-2 had a 0.93-0.96 AUC. Establishing the psychometric properties of anxiety screening measures is crucial in the older adults with cancer to maximize referral efficiency and accuracy. This study indicates that the GAD-7 is reliable and valid for older adults with cancer. Analyses suggest the GAD-2 may be as sufficient as the GAD-7 in identifying anxiety in older adults with cancer, thereby reducing assessment burden.