Ensure Content Validity Research Articles

Revisiting the scientific habits of mind scale for socio-scientific issues in the Indonesian context

ABSTRACTThe purpose of this study was to develop a valid and reliable scale measuring the Indonesians’ scientific habits of mind (SHOM) levels via the SSIs in context. The sample of the study consisted of 658 Indonesian people (aged 18–68 years; 385 females and 273 males; mean age: 35.5) randomly drawn from 3 districts of Special Region of Yogyakarta, Indonesia. To ensure content validity, the researchers matched SHOM (mistrust of arguments from authority, open-mindedness, scepticism, rationality, objectivity, suspension of belief, and curiosity) with the SSIs in the Indonesian context. A group of experts and a pilot study with 10 lay people ensured face validity. Concurrent validity was verified via independent samples t-test. To confirm convergent and discriminant validity, confirmatory factor analysis, and reliability values were calculated. Because the final version (33 items) of the SHOM scale has high validity in content, face, convergent, discriminant, and concurrent, it provides valid conclusions based on the theoretical constructs for the sub-scales. This suggests that the SHOM scale may be adapted or improved for SSIs in different contexts.

A Market-Based Procedure for Assessing and Improving Content Validity

Psychometric validity requires construct, predictive, and content validity. However, existing methods for ensuring content validity are limited in their ability to identify attributes missing from a content domain or attributes that should be removed from a content domain. In particular, rather than capturing how consumers conceptualize a market construct, existing methods capture how consumers respond to how researchers conceptualize a market construct. The authors propose a market-based procedure for capturing how consumers conceptualize market constructs, including metrics for (1) identifying attributes missing from a content domain and (2) attributes consumers consider outside a content domain.

Development and Validity of a Questionnaire on Dyslipidemia Dietary Knowledge

Objective Dyslipidemia is one of the most important modifiable risk factors for cardiovascular disease. Diet and lifestyle interventions positively contribute to the management of dyslipidemia. Adequate knowledge of the correct diet for dyslipidemia is an effective preventive strategy against cardiovascular disease. Method This study developed a questionnaire to test dyslipidemia dietary knowledge. The initial, multiple-choice dyslipidemia dietary knowledge questionnaire (DDKQ) was formed based on a literature review of previous studies. Two Delphi rounds were performed to ensure content validity and face validity, items were pretested and filtered through item analysis, and the reliability and validity of the final questionnaire were checked. Results The DDKQ consisted of 5 parts, with 25 items in total. It demonstrated adequate content validity (0.94), face validity, internal consistency (KR20 = 0.67), and test-retest reliability (0.74). The mean item difficulty (P) was 0.55 and ranged from 0.15 to 0.83, and the mean item discrimination index (D) was 0.36, ranging from 0.21 to 0.58. The questionnaire was also able to distinguish between participants with/without a medical background; medical workers produced significantly higher total scores (16.70±2.84 vs. 14.57±4.26, p< 0.05). Conclusion The DDKQ is a reliable and valid measure of dyslipidemia dietary knowledge. It is suitable for providing scientific assessments for targeted health education interventions.

Validation of training module to increase self-efficacy of adolescent peer counsellors in Indonesia

Background: Peer counsellor programs are one of many countermeasures for current issues in adolescent mental health. Peer counsellors need to have adequate capability and self-efficacy especially in basic counselling skills to be able to help their peers in their daily life. A validated training module for peer counsellors in mental health context has not yet been developed in Indonesia.Aim: This research aims to develop, and evaluate content and empirical validity of a training module for adolescent peer counsellors in Indonesia.Method: A training module was developed based on a systematic literature review. Expert judgment was elicited to ensure content validity, while a quasi-experiment with two groups control design with a pretest and post-test measure was conducted to evaluate empirical validity. Thirty experimental group subjects and 14 control group subjects were involved in this study.Results: Expert judgment showed the training module had satisfactory content validity, fulfilling statistical consensus requirements. Analysis using EffectLiteR showed that peer counsellor training had a significant effect on self-efficacy with a significance score of 0.019 (p < 0.05) for average effect.Conclusion: The module has adequate content and empirical validity to increase counselling self-efficacy in adolescent peer counsellors.

Development and Validation of a Pain Competence Assessment Tool (PCAT) Based on the IASP Core Competencies for Pain Management

ABSTRACTSeveral interprofessional education programs have been developed to enhance primary care providers’ (PCPs) competency in pain management. This project aims to develop a valid and reliable competency-based assessment tool, suitable for all professions, to evaluate the impact of these programs.To develop a new pain competence assessment tool (PCAT), six clinical vignettes were created. Each vignette is followed by questions addressing one or more competencies derived from the core pain competencies developed by Fishman et al. in 2013. Experts in pain management representing different professions were asked to review and rate the appropriateness of the PCAT questions to confirm face validity through a modified Delphi study. The selected PCAT questions were mapped against the core competencies to ensure content validity. A pilot sample of PCPs was then asked to answer the PCAT through a cognitive interview study to assess feasibility. Currently, the PCAT was sent to a large sample of PCPs to assess its reliability through a cross-sectional study. The PCAT was also sent to healthcare prelicensure students to test for construct validity.Based on the Delphi results, nineteen questions were rated as appropriate confirming its face and content validity. The PCAT also showed adequate feasibility based on the cognitive interview study. Psychometric testing is still in process.Future implementation of a valid and reliable tool is necessary to reduce measurement error and produce results with high degree of credibility.Introduction/Aim: Several interprofessional education programs have been developed to enhance primary care providers’ (PCPs) competency in pain management. This project aims to develop a valid and reliable competency-based assessment tool, suitable for all professions, to evaluate the impact of these programs.Methods: To develop a new pain competence assessment tool (PCAT), six clinical vignettes were created. Each vignette is followed by questions addressing one or more competencies derived from the core pain competencies developed by Fishman et al. in 2013. Experts in pain management representing different professions were asked to review and rate the appropriateness of the PCAT questions to confirm face validity through a modified Delphi study. The selected PCAT questions were mapped against the core competencies to ensure content validity. A pilot sample of PCPs was then asked to answer the PCAT through a cognitive interview study to assess feasibility. Currently, the PCAT was sent to a large sample of PCPs to assess its reliability through a cross-sectional study. The PCAT was also sent to healthcare prelicensure students to test for construct validity.Results: Based on the Delphi results, nineteen questions were rated as appropriate confirming its face and content validity. The PCAT also showed adequate feasibility based on the cognitive interview study. Psychometric testing is still in process.Discussion/Conclusions: Future implementation of a valid and reliable tool is necessary to reduce measurement error and produce results with high degree of credibility.

Threats to the Validity of Logistics and Supply Chain Management Research

To increase the relevance of logistics and supply chain academic research, this paper recommends the development and testing of middle‐range theory and practice‐level theory. Yet, there are a number of research issues that arise when academic researchers test middle‐range and practice‐level theory, both in measuring constructs and in testing theoretical relationships between constructs. Concerning the measurement of constructs, this paper recommends that academic researchers pay more attention to content validity and undertake rigorous processes to ensure content validity. In addition, academic researchers need to more explicitly define constructs as either reflective or formative. If the construct is defined as formative, then the traditional statistical approaches to validate these measurement scales are not recommended. The appropriate use of employing single‐item measures for concrete constructs is discussed. In regard to conducting hypothesis tests, research issues associated with multicollinearity and omitted variable bias are discussed. Relative weight analysis is ideal for testing theoretical models and research hypotheses when survey data are obtained, multicollinearity is present, and there are a large number of independent variables predicting a dependent variable. Thus, relative weight analysis is ideal for testing research hypotheses in logistics and supply chain management.

The emerging role of the corporate or system-level infection prevention director for integrated delivery networks

One position in integrated delivery networks (IDNs) that provides centralized oversight to optimize patient safety is the corporate-level infection prevention (IP) director. After noting variability in their roles, responsibilities, and IP programs, a national network of IDN IP directors planned a member survey to better understand common and variable elements. Nine network members volunteered to design a survey to describe the current role, responsibilities, and resourcing of all members of the corporate IP director group. A 17-question survey was designed using the Survey Monkey multiple-choice format with a comment option. The questions were reviewed by the entire network to ensure content validity. The survey was delivered to all 72 network members by e-mail, and a 44% response rate was achieved. Survey responses revealed variation and commonalities relative to role structure, responsibilities, resourcing, and level of physician support for corporate IP directors. In addition, advantages of the position were described. The results of the survey will serve as a foundation on which to build, supporting standardization and reliable design for the role, responsibilities, and resourcing of corporate IP directors, with the ultimate goal of improving patient safety.

Development of a New Tool for Evaluating the Benefit of Preventive Treatments for Migraine on Functional Outcomes - The Migraine Functional Impact Questionnaire (MFIQ).

ObjectiveThe objective of this study was to develop a method for evaluating patient‐relevant outcomes of interventions for preventing migraine attacks, followed by an assessment of the content validity of a new patient‐reported outcome (PRO) instrument: the Migraine Functional Impact Questionnaire (MFIQ).BackgroundThe aim of preventive treatments for migraine is not only to reduce migraine frequency, but also to restore patients’ ability to function and improve quality of life.MethodsA multi‐stage process based on best practice methods and regulatory guidelines for ensuring content validity of PRO instruments for evaluating treatment benefit was followed. Qualitative concept elicitation interviews conducted to understand the experiences of adults with migraine underpinned the development of the instrument. The initial stage included the development of a conceptual disease model (CDM) based on information from these interviews. This CDM was used to identify the concepts of interests (COI) to evaluate outcomes of preventive treatments. The results of the interviews were also used in stage 2, to develop a measurement framework for collecting data about these COI. In the third stage, existing instruments were reviewed for coverage of the concepts in the framework and evidence of concept elicitation to the point of saturation, to support content validity. In the fourth stage, an instrument was drafted to evaluate concepts in the framework, based on the qualitative data collected from the interviews. Following a review by clinical and translation experts, the new instrument was tested in adults with migraine in the fifth stage using 2 rounds of cognitive interviews, and was modified based on interview feedback. In the last stage, the instrument was linguistically adapted, using methods recommended for PRO instruments, to ensure conceptual equivalence of language versions for use in international studies. Each language version was tested in at least 5 native speakers using cognitive interviews.ResultsResults from the concept elicitation interviews suggested that migraine had an impact on various aspects of functioning. A conceptual framework for evaluating functional outcomes was developed for the concept selected based on a review of the CDM – physical and emotional functioning, every day activities, and social/leisure activities. Existing PROs lacked coverage of some concepts in the conceptual framework, had recall periods that were inappropriate for capturing the experience of COI or did not have evidence of content validity. A novel PRO instrument, the MFIQ, was developed to address these gaps. Cognitive interviews with 9 adults with migraine resulted in minor changes to the items of the MFIQ, and a final round of 8 interviews confirmed the changes were acceptable and supported its validity. The interviews conducted to test linguistic adaptations confirmed conceptual equivalence in the 25 countries evaluated.ConclusionsDevelopment of the MFIQ followed best measurement practices to ensure content validity and followed regulatory guidelines for PRO instruments to evaluate benefits of treatments. The MFIQ was developed for use in clinical trials or clinical practice settings to track outcomes of preventive treatments that are most relevant to adults with migraine.

Thai diabetes prevention education program: development and validation of the Thai physical activity questionnaire for at-risk people

This study aimed to develop and validate the Thai physical activity questionnaire (Thai-PAQ) for Thai people at risk for type 2 diabetes (T2D). After development and validation of the questionnaire, 95 people at risk for T2D were recruited. The Thai-PAQ was developed based on the International-PAQ. The Thai-PAQ was evaluated by three experts to ensure content validity. The at-risk people were interviewed using the Thai-PAQ for the previous 7 days’ activities. Spearman’s correlation was used to compare the accelerometer and Thai-PAQ for concurrent validity. Interclass correlation was used to evaluate the reliability of the Thai-PAQ separated by 3 days. Chi-square test was used to represent significant differences (p < 0.05) in the proportion of participants meeting the current physical activity guidelines. The content validity of the Thai-PAQ was 0.91. The total physical activity from the Thai-PAQ (MET-min week−1), which included the part-time occupation domain and excluded the part-time occupation domain, was significantly correlated with the total physical activity (counts week−1) according to the ActiGraph accelerometer (r = 0.57 and 0.54, p < 0.01, respectively). The 3-day test-retest reliability of the total physical activity of the developed PAQ was 0.86 (p < 0.05) when including the part-time occupation domain and was 0.85 (p < 0.05) when excluding the part-time occupation domain. The study showed that that concurrent validity had high correlation compared with the ActiGraph accelerometer. Reliability was also acceptable as high reliability. The Thai-PAQ is considered useful for communities as well as a means to ultimately promote physical activity in communities.

Development of a Learner Autonomy Scale

In distance learning educational context, learner autonomy is an element of research since the decade of 1970. Consequently, there are a lot of theoretical and empirical research of learner autonomy in distance learning trying either to conceptualizing it or to measure it. There are at least eight scales for measuring learner autonomy but all of them have been developed in a different socio-educational context and although it is not a mistake to be used in different socio-educational context it is more appropriate to develop a new one for the specific context. Therefore the aim of this study was to develop a learner autonomy scale that can be used in the context of the Open University of Cyprus and provide psychometric evidence of reliability and validity of the interpretation of the scores derived from the scale. First, the concept of learner autonomy was clarified through literature review. Second information on students’ beliefs and feelings about their learner autonomy was gathered. On the basis of the afore-mentioned procedures, an item pool was developed and was given to fourteen (14) university expertise of distance learning in order to evaluate the items and ensure content validity. Reliability and validity were then tested using exploratory factor analysis with a sample of two hundred and fiftyeight (258) undergraduate and postgraduate students from the Open University of Cyprus. Principal component analysis with oblimin rotation was used to determine the sufficient number of factors. The extraction of the number of factors was based on a) the theory; b) the scree plot test; c) eigenvalue-greater-than-one rule; d) the percentage of explained variance of each factor; e) the percentage of total explained variance and f) the number of factors that can be conceptually interpreted. Four dimensions of learner autonomy, namely, a) special ability to self-management, b) special psychological disposition, c) general ability to self-management and d) general psychological disposition, were revealed. The first factor explained 22.84% of the variance, the second factor 9.13% of the variance, the third factor 7.06% of the variance and the fourth factor 6.36% of the variance. Though some items in this scale were similar to those of other scales, factorial structure was different. Three different possible explanations proposed. The first was based on the differentiations of the educational environments the second on the fact that learner autonomy is a complex concept and therefore different conceptualizations of the term lead to different measurement scales and the third was based on the fact that all the scales measure perceived (form the student perspective) learner autonomy. Cronbach’s alpha for the overall scale was .85, for the factor of special ability to self-management was .82, b) for the factor of specific psychological disposition was .65, c) for the factor of general self-management capacity was .76 and for the factor of general psychological disposition was .48. Finally, the Pillai's Trace showed no statistically significant gender differences in the four factors

Two valid and reliable work role functioning questionnaire short versions were developed: WRFQ 5 and WRFQ 10

ObjectiveThe study aims to develop and validate short versions of the work role functioning questionnaire v2.0 (WRFQ) that retain the measurement properties of the full-length 27-item questionnaire. Study design and settingSix cross-sectional Dutch samples (N = 2,433) were used, containing data on gender, self-rated health, job type, and WRFQ scores. Indicators from classical test theory and item response theory methods were used along with evaluation of translatability and conceptual considerations to identify short version candidate items. To ensure content validity, the item selection was made within the five-factor structure established for the WRFQ—leading to a 5-item and a 10-item short version. Bland-Altman analyses of agreement and interclass correlations with the full WRFQ were used to establish the best scoring procedure. Discriminant validity was evaluated for the short versions and compared with the full-length 27-item version. ResultsBoth short versions showed acceptable agreement with the full-length 27-item version using simple scoring procedures. Both also showed comparable or stronger validity than the full WRFQ in known group comparisons. ConclusionBoth short versions can be used to measure work role functioning in working samples with mixed clinical conditions and job types.

Development and validation of a questionnaire to self-assess patient knowledge of direct oral anticoagulants (KODOA-test).

ObjectiveFew studies have examined associations between patient knowledge of direct oral anticoagulants (DOAC) and clinical outcomes, mostly because of the lack of validated questionnaires for assessing knowledge. The aim of this study was to develop and validate a questionnaire to self-assess knowledge of DOAC.MethodsTwelve anticoagulation experts participated in the questionnaire development process to ensure content validity. The Knowledge Of Direct Oral Anticoagulants (KODOA)-test was submitted to patients on DOAC and to pharmacists to assess construct validity. Responsiveness was evaluated after educational counseling. Test–retest reliability was assessed to ensure stability over time, and Cronbach’s α was calculated for internal reliability. Index of difficulty and item discrimination (D-value) were calculated to assess the performance of single items.ResultsThe KODOA-test contains 15 items with multiple-choice answers. Each correct answer scores 1 point (max. score of 15). The KODOA-test was administered to 32 patients on DOAC and 28 pharmacists. Pharmacists scored significantly higher than patients at baseline (median score 13.3 vs 10.0; p<0.001), supporting construct validity. Patient scores increased significantly after educational counseling (median score 11 [interquartile range 2] vs 14 [interquartile range 3]; p<0.001). Test–retest and Cronbach’s α were acceptable with a Pearson’s correlation of 0.8 and an α of 0.67. The index of difficulty for most items was satisfactory (0.38–0.72) and the mean D-value was 42.5%.ConclusionThe KODOA-test is a brief, valid, and reliable knowledge self-assessment questionnaire that may be used in clinical trials to investigate associations between knowledge increase and patient-related outcomes.

Assessing health-related quality of life in Japanese children with a chronic condition: validation of the DISABKIDS chronic generic module

BackgroundThis study examined the reliability and validity of the Japanese versions of the DISABKIDS-37 generic modules, a tool for assessing the health–related quality of life (HRQOL) of children and adolescents with a chronic condition.MethodsThe study was conducted using a sample of 123 children/adolescents with a chronic medical condition, aged 8–18 years, and their parents. Focus interviews were performed to ensure content validity after translation. The classical psychometric tests were used to assess reliability and scale intercorrelations. The factor structure was examined with confirmatory factor analysis (CFA). Convergent validity was assessed by the correlation between the total score and the sub-scales of DISABKIDS-37 as well as the total score of KIDSCREEN-10.ResultsBoth the children/adolescent and parent versions of the score showed good to high internal consistency, and the test-retest reliability correlations were r = 0.91 or above. The CFA revealed that the modified models for all domains were better fit than the original 37 item scale model for both self-report and proxy-report. Moderate to high positive correlations were found for the associations within DISABKIDS-37 sub-scales and between the subscales and total score, except for the treatment sub-scale, which correlated weakly with the remaining sub-scales. The total score of the child-reported version of KIDSCREEN-10 correlated significantly and positively with the total score and all the sub-scales of the child-reported version of DISABKIDS-37 except the Treatment sub-scale in adolescents.ConclusionsThe modified models of Japanese version of DISABKIDS generic module were psychometrically robust enough to assess the HRQOL of children with a chronic condition.

Development of a New Patient-reported Outcome Instrument to Evaluate Treatments for Scars: The SCAR-Q

Background:Every year millions of individuals acquire scars. A literature review of patient-reported outcome (PRO) instruments identified content limitations in existing scar-specific measures. The aim of this study was to develop a new PRO instrument called SCAR-Q for children and adults with surgical, traumatic, and burn scars.Methods:We performed a secondary analysis of the qualitative datasets used in the development of PRO instruments for plastic and reconstructive surgery, that is, BREAST-Q, FACE-Q, BODY-Q, and CLEFT-Q. The keyword “scar*” was used to extract scar-specific text. Data were analyzed to identify concepts of interest and to form a comprehensive item pool. Scales were developed and refined through multiple rounds of cognitive interviews with patients and with input from international clinical experts between July 2015 and December 2016.Results:A total of 52 children and 192 adults from the qualitative datasets provided between 1 and 34 scar-specific codes (n = 1,227). The analysis led to the identification of 3 key domains for which scales were developed: scar appearance (eg, size, color, contour), scar symptoms (eg, painful, tight, itchy), and psychosocial impact (eg, feeling self-conscious, bothered by scar). Cognitive interviews with 25 adults and 20 pediatric participants with scars, plus feedback from 27 clinical experts, led to rewording and removal of items, and new items added. These steps ensured content validity for SCAR-Q in a broad range of scars.Conclusions:The SCAR-Q is now being field-tested. Once completed, we anticipate SCAR-Q will be used in clinical practice and in clinical trials to test different scar therapies.

A cross-sectional survey of child abuse management knowledge among emergency medicine personnel in Cape Town, South Africa.

IntroductionChild abuse is a common condition in the emergency centres of South Africa. It is critical for both prehospital emergency care practitioners and emergency centre-based emergency medicine registrars to be competent in screening, diagnosing, treating, and documenting child abuse. Our goal was to assess the knowledge of child abuse management in a sample of prehospital emergency care practitioners and emergency medicine registrars in Cape Town, South Africa.MethodsA mixed-methods approach of quantitative and qualitative data was used to survey a sample of 120 participants (30 emergency medicine registrars and 90 prehospital emergency care practitioners: 30 Basic Life Support, 30 Intermediate Life Support, and 30 Advanced Life Support). An expert panel created the survey to ensure content validity and survey questions were designed to assess the perceived and actual knowledge of participants. We hypothesised that there would be significantly higher levels of perceived and actual knowledge in emergency medicine registrars compared to emergency care practitioners. An open-ended question on how participants felt dealing with child abuse was qualitatively analysed using thematic analysis.ResultsThere were significant differences in the levels of perceived knowledge (58% of emergency medicine registrars agreed that they felt adequately trained overall, versus 39% of emergency care practitioners; −19% difference, 95% CI −26% to −12%) and actual knowledge (83% of emergency medicine registrars with correct answers, versus 62% of emergency care practitioners; −21% difference, 95% CI −26% to −16%) among participants. Themes that emerged from qualitative analysis included personal distress, retaliation, frustration, medical system frustration, and personal competence concerns.DiscussionSignificant perceived and actual knowledge deficits of child abuse management exist among both emergency care practitioners and emergency medicine registrars in this setting. Future interventions should address the need for guidelines and increased training opportunities to ensure the health and safety of abused children.

Development of a Measurement Tool to Assess Students' Knowledge and Perceptions About Cancer (SKPaC).

Cancer literacy is currently one of the most important dimensions of cancer continuum. Objective assessment of cancer knowledge in populations remains a challenging field to public health entities. Different evaluation tools are currently available; still, some groups remain disregarded due to the absence of validated instruments. Cancer literacy in adolescents and young adults has been clearly overlooked being a subject that requires new tools to be properly studied. To address this topic, we developed a new instrument and field tested it in a classroom environment for internal reliability, construct, and face validity. "Students Knowledge and Perceptions about Cancer questionnaire" was designed in Portuguese language and adapted to the Portuguese context by a multidisciplinary team. The final version of the questionnaire includes 35 items organized in three sections, encompassing knowledge and perceptions about cancer and socio-biographic data. Cancer experts ensured content validity, while tailoring of contents was refined with high school teachers. Test and retest of the instrument showed a good reliability of the scale and construct validity. Also, the clarity of the questionnaire and suitability to proper evaluate cancer knowledge was consistent between test and retest. The Students' Knowledge and Perceptions About Cancer Questionnaire (SKPaC) showed to be a valid tool to assess adolescents' knowledge and perceptions about cancer that can be used in the educational context.

Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

Development of a Nursing Protocol for Hospitalized Patients with Reduced Cognitive Function in the Process of Recovery from Acute Exacerbation of Chronic Heart Failure

The purpose of this study is to develop a nursing protocol aiming at early recovery of hospitalized patients with reduced cognitive functions in the process of recovery from acute exacerbation of chronic heart failure. At the first stage of the research, a draft nursing protocol was prepared based on a basic survey. At the second stage of research, a semi-structured interview was conducted for 4 nurses certified for chronic heart failure nursing and 11 nurses certified for dementia nursing so as to ensure content validity of the draft nursing protocol. At the third stage of the study, the possibility of clinical application of the nursing protocol revision plan proposed at the second stage of the study was examined. The nursing protocol revision plan was effective for 118 nurses (90.1%) who carried out the protocol for the target patient on assessment items, essential points of nursing care and specific nursing care. There were no items or contents for which confirmation of usefulness was less than 60%. Since 90.1% of the usefulness was confirmed by nurses working in the actual clinical setting, the authors believe that this nursing protocol was secured to a certain level. The nursing protocol developed in this study has been requested by nurses at clinical sites in the past. It is very meaningful in improving nursing for the early recovery of hospitalized patients with reduced cognitive function in the process of recovery from acute exacerbation of chronic heart failure.

A Textual Measure of Business Strategy

This paper uses text parsing analysis on managerial self-disclosure in regulatory Form 10-K and develops a three-dimensional measure of business strategy for a large sample over 22 years. To ensure content validity, we draw the keyword list from prior literature. Adding to the face validity of the three-dimensional measure, we show that the measure exhibits substantial variation across and within industries and changes over time in responding to economic shocks. We also observe an overall persistent trend of the measure, indicating that the measure has high test-retest reliability. Further, we examine construct validity and find that the measure behaves as theory predicts. We find evidence that different strategies imply different resource allocation to strategic investments, affect important earnings properties and accounting policies, and have different implications on firm performance.

Development of Nursing Protocol for Preventing Interruptions during Clinical Examinations and Treatments in the Early Days of Hospitalization for Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing interruptions during clinical examinations and treatments performed in the early days of hospitalization for acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the research, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 11 nurses in dementia care to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 73 subjects (84.9%) considered effective for patients, in terms of prevention of interruptions during clinical examinations and treatments in the early days of hospitalization. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 84.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We consider that this nursing protocol will be useful especially for newly graduated/employed nurses as a procedure manual which can reduce their anxiety or stress caused by lack of knowledge or experiences.