Face Validity Research Articles

Motor development and functional ability for children with cerebral palsy: A new tool for functional measure

The paucity of adequate tool available for documenting therapeutic effectiveness surfaces as major problem. An initiation is being taken to develop an appropriate tool which can evaluate motor development and functional ability of children with Cerebral palsy appropriate to Indian culture and society. Aim: To develop an assessment tool for analysing motor development and functional ability of children with Cerebral palsy. Objectives: (i) To develop Psychometric property and evaluate the psychometric property of the tool. (ii) To check the reliability and validity of the tool developed. Material and method: Tool development was conducted in three phases, Phase 1- development of 64 items in three domains. Expert review was undertaken and correction of the content was done through discussion with experts. Phase 2- content validity and face validity have been established. Phase 3 - concurrent validity, has been established by corelating with GMFM. Result: 64 items were generated under three stages: Infant (20), Toddler (36) and Preschooler (8). Content validity index at item level and Scale level were significantly high (> 0.80) for agreement in Clarity, Essential and Relevancy. The face validity of the tool was evaluated. Each item was under full agreement category (90% -100%) in formatting, clarity, and appropriateness of the item for children with CP. Test-retest, interrater and concurrent validity of the tool is significantly acceptable. Conclusion: The new tool may be considered as an effective measure which is suitable in children with CP.

Validity, Reliability, and Cultural Adaptability of the Arabic Cognitive Flexibility Scale (Ar-CFS) Among Saudi Arabians: A Two-Cohort Investigation.

Background/objectives: Cognitive flexibility is the mental skill that allows a person to shift between different ideas or concepts and think about several concepts simultaneously. A commonly used tool to assess cognitive flexibility is the Cognitive Flexibility Scale (CFS). This study focused on translating and validating the CFS into Arabic, given the lack of existing Arabic tools for assessing cognitive flexibility. Methods: Conducted at King Saud University, Riyadh, between April and June 2024, the study employed random sampling and involved 529 participants, including 419 students and 110 patients. Results: The average participant age was 25.8 years, with females making up 56.9% of the sample. Participants completed the Arabic CFS, along with the Emotion Regulation Questionnaire (ERQ) and the Perceived Stress Scale (PSS), at two time points 3-6 weeks apart. Reliability was evaluated through internal consistency (Cronbach's alpha = 0.8) and test-retest reliability (intraclass correlation coefficient = 0.82). Item analysis indicated that removing any single item did not significantly impact overall reliability, and inter-item correlations were strongest between items 4 and 6 (0.55) and items 6 and 7 (0.51). Validity was assessed through face, content, and construct validity, with factor analysis revealing a dominant single component accounting for 34.4% of the variance, confirming the scale's unidimensionality. Content validity indices for all items exceeded 0.9 in terms of relevance, importance, simplicity, and clarity. The Arabic CFS demonstrated good construct validity, showing significant correlations with the ERQ's reappraisal and suppression dimensions and the PSS. Conclusion: In conclusion, the Arabic version of the CFS is a valid and reliable tool for assessing cognitive flexibility in Arabic-speaking populations. This tool will be valuable in both clinical and research settings within Saudi Arabia, offering a robust instrument for evaluating cognitive flexibility.

Psychometric Properties of the TWente Engagement with Ehealth Technologies Scale (TWEETS) Among Patients with Hypertension in Italy.

Engagement with mobile health (mHealth) technologies among patients with hypertension is linked to reduced blood pressure and improved patient understanding of the condition. This study aimed to evaluate the psychometric properties (validity and reliability) of the TWente Engagement with Ehealth Technologies Scale (TWEETS) in an Italian cohort with hypertension. This study is the first attempt to evaluate the psychometric characteristics of the TWEETS in this population. The study was conducted in three phases. The first phase encompassed the translation and cultural adaptation of the TWEETS to the Italian setting. The second phase involved an expert panel evaluating the instrument's face and content validities. The third phase wasa cross-sectional study aiming to test construct validity and reliability. Adults diagnosed with hypertension were eligible for participation. Additional inclusion criteria included stable antihypertensive treatment for at least 2 weeks before enrolment and the provision of written informed consent. Patients were taught how to use two mHealth devices using the teach-back method. A total of 131 patients were enrolled. Exploratory and confirmatory factor analyses revealed that the TWEETS had a one-factor structure and a good level of fit. Cronbach's alpha coefficients suggested good internal consistency. The findings indicate that the TWEETS is a valuable tool for assessing the engagement of patients with hypertension with mHealth devices. Further assessment is needed in various cohorts to confirm the psychometric equivalence of the construct across different groups with hypertension.

Revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0): cultural adaptation, validity and reliability of the Malay version

BackgroundSurveys on Patient Safety Culture™ Hospital Survey (HSOPSC) developed by the U.S. Agency for Healthcare Research and Quality (AHRQ) has been adopted worldwide. The Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was released in 2019, but there have been no publications to date of its translation and validation for use in Malaysia. This study aimed to translate and cross-culturally adapt the revised HSOPSC 2.0 into the Malay language and determine its psychometric properties including the content, face, and construct validity, and reliability analyses.MethodsThis study was conducted from April – June 2023 and divided into three stages: translation and cultural adaptation; content and face validation; and construct validation using confirmatory factor analysis and reliability testing among 319 healthcare personnel from a public university hospital in Malaysia.ResultsThe translated instrument demonstrated excellent content validity (I-CVI = 0.80 ~ 1.0, SCVI-average = 0.96) and face validity (I-FVI = 0.80 ~ 1.0, SFVI-average = 0.98). Reliability testing was acceptable (Cronbach’s α = 0.60 ~ 0.80) but indicated that reverse-coded items were poorly perceived. Confirmatory factor analysis showed a satisfactory model fit for the translated instrument (RMSEA = 0.08, GFI = 0.80, CFI = 0.80, and χ2/df = 2.96). Six items had very low factor loadings (< 0.40), with two constructs “Staffing and Work Pace” and “Response to Error” having AVE < 0.4, but acceptable CR ≥ 0.6. No items were removed from the questionnaire despite low factor loadings following a consensus from an expert panel.ConclusionThe Malay version of the HSOPSC 2.0 containing ten domains and 32 items demonstrated satisfactory psychometric properties following expert consensus, with acceptable reliability and construct validity for measuring patient safety culture. Given factor loadings smaller than 0.40 in six items, broader validation is suggested to support the use of the translated instrument in the Malaysian healthcare setting.

Face and content validity of the EMPOWER-UP questionnaire: a generic measure of empowerment in relational decision-making and problem-solving

BackgroundDecision-making and problem-solving processes are powerful activities occurring daily across all healthcare settings. Their empowering potential is seldom fully exploited, and they may even be perceived as disempowering. We developed the EMPOWER-UP questionnaire to enable assessment of healthcare users’ perception of empowerment across health conditions, healthcare settings, and healthcare providers’ professional backgrounds. This article reports the initial development of EMPOWER-UP, including face and content validation.MethodsFour grounded theories explaining barriers and enablers to empowerment in relational decision-making and problem-solving were reviewed to generate a preliminary item pool, which was subsequently reduced using constant comparison. Preliminary items were evaluated for face and content validity using an expert panel of seven researchers and cognitive interviews in Danish and English with 29 adults diagnosed with diabetes, cancer, or schizophrenia.ResultsA preliminary pool of 139 items was reduced to 46. Independent feedback from expert panel members resulted in further item reduction and modifications supporting content validity and strengthening the potential for generic use. Forty-one preliminary items were evaluated through 29 cognitive interviews, resulting in a 36-item draft questionnaire deemed to have good face and content validity and generic potential.ConclusionsFace and content validation using an expert panel and cognitive interviews resulted in a 36-item draft questionnaire with a potential for evaluating empowerment in user-provider interactions regardless of health conditions, healthcare settings, and healthcare providers’ professional backgrounds.

Development and validation of the Behavioral Determinants of Deprescribing Questionnaire (BDDQ)

Abstract Background Deprescribing is a strategy to optimize medication use. While health behaviour can successfully be predicted by health behavior theories, the literature on deprescribing relies almost exclusively on questionnaires that measure attitudes only, such as the Beliefs about Medicines Questionnaire and the Patients Attitudes Towards Deprescribing, resulting in poor predictive validity. The aim of this study was to develop a new tool to measure the psychological determinants of deprescribing among people aged over 60, based on concepts derived from health behaviour theories. Methods A draft self-report questionnaire was developed consisting of 64 questions measuring 11 dimensions representing determinants of deprescribing. As well as previous deprescribing experience, current deprescribing behaviour and willingness to deprescribe. Face validity was assessed by asking 10 health professionals and 13 of older people to complete the questionnaire and comment in a small group discussion, resulting in the removal of 18 items. Construct validity was assessed on a sample of 103 participants aged over 60, using exploratory factor analysis (EFA). Internal consistency was assessed via Cronbach’s alpha. Results The EFA could confirm 11 dimensions explaining 70,5% of the total variance, but revealed poor loadings for several items and inadequate alphas (&amp;lt;.50) for two factors. Removal of items and these two dimensions resulted in 26 items measuring 9 dimensions, all showing acceptable internal consistencies (between .52 and .77): perceived risk; relatives’ involvement; deprescribing concerns; attitudes; medication beliefs; healthcare support; perceived difficulties; motivation to comply; communication accessibility. Conclusions This study produced a conceptually based and psychometrically validated questionnaire to assess behavioural determinants of deprescribing. It provides for a more comprehensive investigation of deprescribing intentions and behaviour of older adults. Key messages • A conceptually sound, psychometrically validated questionnaire (BDDQ) was developed. • BDDQ can be used for a more comprehensive study of de-prescribing in older people.

Development of a novel Patient-Reported Outcome Measure (PROM) for adults with an Inherited Cardiac Condition (ICC)

Abstract Background Research on the quality-of-life (QoL) among patients with inherited cardiac conditions (ICC) is limited. Existing evidence from a systematic review indicates that most studies rely on generic measures of health-related QoL, which may not adequately capture ICC-specific factors. The current study aims to develop a disease-specific patient-reported outcome measure to address this gap. Methods Using a qualitative study design, we first conducted focus groups until data saturation was achieved (n=15). Additionally, an expert panel of healthcare professionals was interviewed to ascertain their perspectives on patient-centered care and to evaluate face validity. Transcripts of all focus groups and interviews were analyzed thematically using Atlas.ti, qualitative analysis software, to identify concepts and formulate survey items for the initial instrument. We used the ‘Centre for Health Promotion’ QoL model, consisting of three domains- Being, Belonging, and Becoming- as the theoretical framework for our analysis. Results Our analysis revealed alignment with specific QoL domains of the overarching framework and identified a gap in genetic-specific domains. A novel overarching theme, genetic well-being, was identified, encompassing specific constructs related to future uncertainty, reproductive concerns, and the anticipation of disease development, thus enriching the conceptualization of QoL in the context of inherited cardiac conditions. The discussion will include an exploration of the face validity of the draft instrument. Conclusion Patients diagnosed with an inherited cardiac condition (ICC) face a spectrum of challenges originating from both disease-related stressors and hereditary factors alike. Recognizing that relying solely on objective clinical assessment may fail to capture the full impact of the disease, there has been an increasing focus on incorporating patient-reported measures into disease evaluation. This qualitative study contributes to developing a comprehensive patient-reported outcome measure tailored to individuals with ICC.PROM development study

Developing a Questionnaire to Assess Self-Efficacy in the Teaching Profession

In Japan, school teachers experience mental health issues, leading to absences or leave from their duties. While extended working hours significantly contribute to this problem, diminished self-esteem has emerged as the primary causal factor. Reduced self-esteem is frequently correlated with diminished self-efficacy across multiple facets of teaching. Consequently, fostering self-efficacy in the teaching profession is essential for preventing health-related problems. In this regard, early intervention among students aspiring to become school teachers is crucial for prevention. This study aimed to develop a self-efficacy questionnaire tailored for students pursuing teaching careers, as effective preventive interventions require scales to evaluate self-efficacy. Following the development of an original questionnaire with both content and face validity, a web-based survey was administered to the participants via a Japanese survey company. The analysis included 422 participants (176 males and 246 females). Exploratory and confirmatory factor analyses confirmed factorial validity, identifying three distinct factors: collaboration with others, student guidance, and classroom and teaching management. Additionally, a higher-order factor denoting global self-efficacy in the profession emerged from the total scores of these three factors. Internal consistency was observed across all subscales and the global scale, with scores demonstrating an undistorted distribution, indicative of a normal distribution. The study concludes with a discussion of its limitations and suggestions for future research. This questionnaire could facilitate the implementation of diverse interventions aimed at promoting teachers’ well-being and adaptability.

Knowledge, opinions and experiences of nurses and nursing students in Portugal regarding the use of medical Cannabis

BackgroundThe opening up of the laws to medicinal cannabis in recent years is a key factor in the growth of this therapy, but there is little information about what nurses know and think about it. The present paper seeks to analyze the knowledge, opinions, and experiences of nurses and nursing students in Portugal regarding the use of cannabis and to understand gender differences.MethodsA self-completion questionnaire was drawn up and published online. It received face and content validity and was approved by the Ethics Committee. The instrument includes socio-demographic data, questions about knowledge, opinions, experiences, and training in cannabis. The data was collected and processed by applying descriptive and inferential statistics using the chi-square test and Fisher’s exact test on the SPSS platform.ResultsThe majority of the 610 participants were women. The therapeutic benefits of medical cannabis were appreciated by 79,6% of nurses and 84,3% of students. When asked about the functions of the endocannabinoid system, 71,7% of nurses and 79,5% of students had never heard of it. There is a statistically significant gender difference concerning personal experience of cannabis use to treat symptoms or illnesses.ConclusionsAs the levels of knowledge were low and a minority had education on medical cannabis, there is a need for further education of nurses and for this emerging area to be included in the curricula.

Psychometric Properties of the Chinese Version of the Psy-Flex Among Parents of Children with Autism Spectrum Disorder.

This research aimed to translate the original English version of the Psy-Flex, a scale of psychological flexibility, into Chinese and to test its psychometric properties among parents of children with autism spectrum disorder (ASD). Two phases were conducted: (1) translation from English to Chinese (Psy-Flex-C), followed by a semantic equivalence evaluation between two versions, a pre-test, and an evaluation of the Psy-Flex-C in terms of face validity with 20 parents of autistic children, and content validity of the Psy-Flex-C with eight experts. (2) A cross-sectional study with 248 parents of autistic children was conducted for validation, and a subgroup of 50 participants was randomly selected to assess the test-retest reliability at a 2-week interval. The Psy-Flex-C showed satisfactory semantic equivalence with the original version and demonstrated adequate internal consistency (Cronbach's α = 0.84) and test-retest stability (weighted kappa statistic = 0.88). Concurrent validity was supported by a moderate correlation between the Psy-Flex-C and the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (Pearson's r = 0.54, p < 0.01). The Psy-Flex-C showed a significant mean score difference between parents with high and low parenting stress (t = 5.43, p < 0.001). Similar to the original scale, confirmatory factor analysis showed the best fitting one-factor structure of the Psy-Flex-C (X2/df = 1.62, p = 0.13, RMSEA = 0.05, GFI = 0.99, CFI = 0.99, TLI = 0.98, SRMR = 0.023). The Psy-Flex-C can be a reliable and valid instrument to self-report psychological flexibility in parents of children with ASD. Future research is recommended to test the Psy-Flex-C using diverse samples from different cultures and contexts to enhance its generalizability.

Realization of environmentally friendly behaviours in sports from the point of view of managers and organizers

Introduction: The purpose of this study was to realize environmentally friendly behaviors in sports from the point of view of managers and organizers of sports events. Methodology: In order to collect data, a 4-part researcher-made questionnaire including 40 questions was used. The face and content validity was confirmed by a survey of related faculty members, and its reliability was reported using Cronbach's alpha of 0.83. The statistical sample of the research consists of managers and organizers of sports events in ten provinces of the country. After distributing the questionnaires, finally 254 questionnaires were returned. Results: Data analysis was done using Amos and SPSS-19 software. Pearson's correlation coefficient and path analysis were used to test hypotheses, and bootstrap method was used to test indirect relationships (mediation). The proposed model was also tested to investigate the relationships between the factors. The results showed that the three factors of environmental awareness, perception of environmental effects, and the intention to support green sports events affect the actual environmental friendly behavior. Also, the results showed that the variable that intends to support green sports events plays a role as a mediating variable and the extent of the impact of environmental awareness and perception on the actual environmentally friendly behavior is caused by the intention to support green sports events. Conclusions: Based on the proposed research model, the environmentally friendly behaviors of sports event organizers and managers and their intention to protect green sports events are largely influenced by their knowledge and understanding of environmental issues. It seems that understanding the basic factors affecting people's actual and supportive behaviors towards green sports is necessary to promote environmental behavior.

Developing and validating a scale for English-medium instruction pedagogical competency in multilingual and multicultural classrooms

ABSTRACT This study aimed to create a scale that is better aligned with and tailored to the needs and perspectives of students for evaluating teachers’ EMI pedagogical competency in the multilingual and multicultural higher education context. Based on a literature review, a preliminary scale was developed. After an expert survey of six EMI experts to ensure face and content validity, exploratory and confirmatory factor analyses were conducted to validate the scale by examining its convergent validity, discriminant validity, and internal consistency. The result suggested that the scale was comprised of 22 items and 3 factors, viz., ‘general EMI pedagogical competency’, ‘adapt teaching to adjust for variation in culture and academic/linguistic ability’, and ‘boosting student involvement and positive affection toward EMI. The scale exhibited adequate reliability and validity and could be employed to evaluate tutors’ EMI competency in multilingual and multicultural classrooms. This study argued that in addition to possessing general EMI pedagogical competency, teachers should also develop additional competency related to widely-discussed student EMI anxiety and multilingual and multicultural backgrounds. This scale could serve as a framework for EMI professional development in the higher education sector, but also a tool enhancing teachers’ reflexivity in their EMI practice.

Face and Content Validation of Artificial Temporal Bone Dissection for Otolaryngology Training.

Face and Content Validation of Artificial Temporal Bone Dissection for Otolaryngology Training.

French translation and transcultural adaptation of the shoulder pain and disability index (SPADI)

BackgroundA French version of the Shoulder Pain and Disability Index (SPADI) is currently unavailable for clinical and research use in French-speaking countries. ObjectivesTo translate and transculturally adapt the Shoulder Pain And Disability Index (SPADI) from English to French language. DesignTranslation and transcultural adaptation of a Patient-Reported Outcome Measure. MethodsFollowing international guidelines for translating and adapting PROMs, we carried out a seven-step process involving 15 contributors. The forward translation was performed by five independent native French speakers, while five independent native English speakers conducted the blinded back-translation. A bilingual expert committee synthesized the translations, and three healthcare professionals participated in the pre-test phase. Ten patients were involved in pre-testing to evaluate the pre-final version. ResultsA final French version of the SPADI was achieved after making seven adjustments across the 18 items, instructions, and examples on the Likert scale. Changes were implemented only if at least 20% of the pre-test participants suggested modifications to enhance readability or coherence. Face validity was assessed by the expert committee. ConclusionThe French version of the SPADI is now available, enabling condition-specific self-assessment and quantitative follow-up of shoulder pain and function in both clinical practice and research. Although psychometric properties of this version are yet to be assessed, future studies are expected to confirm the preservation of the original tool's validity and reliability.

The mSQUASH is a feasible and valid measurement tool to uniformly assess daily physical activity in patients with rheumatic diseases

BackgroundThe modified Short QUestionnaire to ASsess Health-enhancing physical activity (mSQUASH) was originally developed and validated in Dutch patients with axial spondyloarthritis (axSpA). To support world-wide distribution, applicability and comparability of...

Visual Snow Syndrome is unstable: A longitudinal investigation of VSS symptoms in a Naïve population.

This study aimed to investigate the nature of subclinical Visual Snow Syndrome (VSS). We sought to develop a means of recruiting naïve participants with subclinical VSS symptoms to participate in research; and to understand whether subclinical VSS symptoms are stable across time. VSS is a recently characterised neurological condition, whose primary symptom is visual snow (dynamic noise in the visual field). There is evidence that VSS may be common in the general population and that it is unnoticed by many who experience it. To fully characterise VSS, it is important to understand whether (and how) subclinical VSS progresses to a clinical form. Here, we present two related studies: Study 1 develops and validates the Melbourne Visual Snow Questionnaire (MVSQ), a tool for screening the general populationfor VSS symptoms; and Study 2 investigates the stability of subclinical VSS. We developed the MVSQ based on the results of other recent work investigating undiagnosed cases of VSS, and a validated questionnaire designed to identify people with tinnitus for research participation. We then tested the MVSQ in a population with clinical VSS, including assessing face validity (i.e., the extent to which people with clinical VSS believed the questionnaire accurately captured their symptoms). In Study 2, we deployed the MVSQ in a naïve sample of 155 participants, who completed the MVSQ twice, 6 weeks apart. The results of Study 1 indicated that the MVSQ was a viable method of recruiting people who experience VSS symptoms for research participation. It was deemed to have appropriate face validity and to pose little burden to those who completed it. In Study 2, VSS symptoms changed substantially across a 6-week period. Cohen's weighted kappa for diagnosis was 0.56, 95% CI [0.43, 0.69]. However, the impact of perceptual experiences was low and did not change over time, rank ICC = 0.71, 95% CI [0.59, 0.82]. The MVSQ is appropriate for assessing perceptual experiences in the general population. Determining the exact time scale across which symptoms fluctuate is important for understanding both clinical and subclinical cases of VSS.

'Development and Psychometric Testing of the Lean Management Scale for Nursing Services in Hospitals'.

The aim of this study is to develop a new instrument (The Lean Management Scale for Nursing Services in Hospitals- LMS-N) to evaluate the lean levels of nursing services in hospitals and to evaluate its psychometric properties. A three-phase construct was used to develop this scale and to determine its psychometric properties: (1) creating the item pool, (2) preliminarily evaluating items and (3) evaluating psychometric properties. This methodological study evaluated the scale's face, content and construct validities, internal consistency, and temporal stability. The psychometric properties of the scale were tested with a total of 695 nurses in different sample groups. Data were collected between 18 November 2020 and 15 May 2021. The scale's content validity index was 0.75. According to principal component analysis, the scale included 22 items and five subdimensions, and the total variance was 60.32%. In confirmatory factor analysis, the fit indices were good or acceptable for this construct. Its internal consistency was good or acceptable according to reliability analysis. Test-retest showed that the scale had temporal stability. Lean Management Scale in Nursing Services in Hospitals is a valid and reliable tool that can evaluate the level of leanness of nursing services. It provides a comprehensive evaluation with five subdimensions: management support, visual stock management, work environment layout, preventive notification system and waste detection.

Validity and reliability of the new NIMHANS intellectual disability screening instrument (NID-Screener) for children and adolescents in India

IntroductionThere is a gap in tools specifically designed for assessing Intellectual Disability (ID) in Indian settings. To address this, the NIMHANS intellectual disability screening instrument (NID-Screener) was developed by the Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences. MethodsTen non experts/language and ten experts rated face and content validity of NID-Screener respectively. Content validity was measured by Content Validity Ratio, Content Validity Indices (I-CVI, S-CVI) and Modified Kappa statistics. Construct validity was calculated by performing Exploratory Factor Analysis(EFA) on responses from 275 parent(s)/guardian(s) of children and adolescents (6–17 years). Criterion Validity was tested against Brief Intellectual Disability Scale (BIDS) and Clinical Diagnosis by Child and Adolescent Psychiatrist. Kappa Statistics was used to calculate inter – method and inter-Rater Reliability. Cronbach’s alpha was used to assess Internal Consistency. This study was approved by NIMHANS ethics committee. ResultsFindings revealed that NID-Screener has good face and content validity (S-CVI/Average = 0.917). Criterion Validity was excellent (Kappa Value=0.862, p-value<0.001) when compared with BIDS. Sensitivity and specificity were found to be 84.7 %, 89 % respectively against Clinical Diagnosis. On EFA, only one underlying factor with Eigen value > 1 was identified (55.8 % of total variance). Kappa value was found to be 0.971 and 0.942 for inter- rater and inter –method reliability respectively(p-value<0.001). NID-Screener has good internal consistency [Cronbach’s alpha = 0.841]. ConclusionsNID-Screener is a reliable and valid tool for screening ID among children and adolescents in India, facilitating its early detection through diagnostic assessments and subsequent interventions.

Days at Home After Traumatic Brain Injury: Moving Beyond Mortality to Evaluate Patient-Centered Outcomes Using Population Health Data.

Administrative data are invaluable for assessing outcomes at the population level. However, there are few validated patient-centered outcome measures that capture morbidity following traumatic brain injury (TBI) using these data. We sought to characterize and validate days at home (DAH) as a measure to quantify population-level outcomes after moderate to severe TBI. We additionally assessed the earliest feasible outcome assessment period for patients with TBI using this outcome measure. This multicenter retrospective cohort study used linked health administrative data sources to identify adults with moderate to severe TBI presenting to trauma centers in Ontario, Canada, between 2009 and 2021. DAH at 180 days (DAH180 days) reflects the total number of days spent alive and at home excluding the days spent institutionalized across care settings. Construct validity was determined using hierarchical quantile regression to assess the associations between clinical and injury covariates with DAH180 days. Predictive validity was assessed using Spearman rank correlation. We estimated minimally important difference (MID) in DAH180 days to aid with outcome measure interpretability. There were 6,340 patients who met inclusion criteria. Median DAH180 days was 70 days (interquartile range 0-144). Mortality occurred in 2,162 (34.1%) patients within 90 days following injury. Patients in the lower DAH180 days group were more commonly older (absolute standardized difference [ASD] = 0.68) with higher preinjury health resource utilization (ASD = 0.36) and greater injury severity (ASD = 0.81). Increased baseline health resource utilization (-10.1 days, 95% CI -17.4 to -2.8, p = 0.0041), older age (-4.6 days, 95% CI -5.7 to -3.4, p < 0.001), higher cranial injury severity (-84.6 days, 95% CI -98.3 to -71.0, p < 0.001), and major extracranial injuries (-14.2 days, 95% CI -19.5 to -8.93, p < 0.001) were significantly associated with fewer DAH180 days. DAH180 days was positively correlated with DAH at up to 3 years (r = 0.91, 95% CI 0.90-0.92) and negatively correlated with direct health care expenditure (rs = -0.89, 95% CI -0.88 to -0.90). The average MID estimated from anchor-based and distribution-based methods was 18 days. We validate DAH180 days as a potentially useful outcome measure with construct, predictive, and face validity in a population with moderate to severe TBI. Given the intensity of acute care requirements for patients with TBI, our work highlights DAH180 days as a feasible and sufficiently responsive outcome measure.

Employee Perceptions and Intention to Leave Among Academic Staff in Public Universities in Kenya

Purpose: The specific objectives of the study included perceived organizational support, commitment, performance and perceived organizational support as predictors of intention to leave. Methodology: The descriptive survey research designs was adopted. The population consisted of all cadres of academic staff in the chosen three public universities in Western Kenya. Yamane’s (1967) formula was utilised in determining a sample size of 121 respondents. Purposive sampling technique was utilised in coming up with the sample. Questionnaires were used to obtain primary data for analysis. A pilot study was done on 5% of the sample and Cronbach’s alpha helped in testing reliability. Both face and content validity of the research instrument were checked. Descriptive and inferential statistics of frequencies, means and standard deviation and inferential technique were utilised to analyse quantitative data using SPSS. Findings: The results revealed that perceived organizational support had a negative significant relationship with intention to leave. Perceived commitment, performance and manager support were all positively related with intention to leave. Unique Contribution to Theory, Policy and Practice: The study recommends that universities should assess and improve employee perceptions if they want to influence them to stay longer with the firms.