Factor Structure Research Articles

Development and Validation of the Internalized Care Stigma Scale (ICSS): Measuring care stigma aimed at informal care for older adults in Germany.

In this study we developed and validated the Internalized Caregiver Stigma Scale (ICSS) to measure internalized stigma targeting informal care for older adults (≥60 years) in Germany. The ICSS scale was developed in the Attitudes Towards Informal Caregivers (ATTIC) project based on stigma theories and (cognitive) pretesting with informal caregivers. Informal long-term caregivers (aged ≥40 years; n=433) of older relatives (aged ≥60 years) were quota-sampled from the online panel GapFish in December 2023 (twice as many female and middle-aged (aged 40-64 years) caregivers than male and younger (18-39 years) or older adults (65+ years) were included in the sample). Caregiver identification and the Social Impact Scale were used for validation of the newly developed measure. Factor structure, reliability and concurrent validity were tested. A correlated two-factor model with excellent goodness of fit criteria and good to excellent internal consistency of the factors and the total scale was confirmed for the ICSS. The negative ICSS subscale correlated highly, and the positive ICSS subscale correlated weakly, with the care-specific Social Impact Scale. Both ICSS subscales were weakly correlated with caregiver identification. Both aspects of self-stigma showed significant associations with sociodemographic and care-specific factors in the regression models. The ICSS is the first scale measuring internalized stigma targeting informal care for older adults directly and shows excellent psychometric criteria. It provides the necessary tool for a new approach to analyze the complex psychosocial mechanisms in this highly relevant care context.

Measuring scientific classroom discourse: The DiISC Version 2.0's validity and use in observing secondary science lessons

AbstractTo continue to support long‐term, ongoing science curriculum and instruction reform efforts in the United States, there is a significant need to be able to reliably measure teachers’ discourse‐rich, inquiry‐based instruction. In this external validation study, we present the Discourse in Inquiry Science Classrooms Version 2.0 (DiISC 2.0) as a valuable observational instrument for researchers to investigate multiple aspects of science teachers' lessons. The DiISC 2.0 is grounded in a researchbased conceptual framework of a scientific classroom discourse community, focused on fundamental socioconstructivist characteristics of lessons, including scientific inquiry, oral and written discourse, and academic language development. We collected and analyzed new data from 807 science lessons to develop and expand the instrument's original validity argument beyond the associated professional development program for broader use. We determined the DiISC's factor structure and examined its correlation with the Electronic Quality of Inquiry Protocol. Finally, some items that did not represent DiISC constructs were removed. Thus, the DiISC 2.0 instrument can be used to measure students’ opportunities to learn science and provide feedback to teachers on their progress toward building an inclusive scientific classroom discourse community for all students, in particular, historically marginalized groups and multilingual learners.

A psychometric appraisal of a revised preparedness for medication administration questionnaire in final-year undergraduate nursing students: a secondary analysis

BackgroundStudents must be prepared for the transference of medication administration (pharmacology knowledge and clinical skills) to clinical practice. The Preparedness for Medication Oral Administration questionnaire has been used in several studies and demonstrated strong internal reliability and consistency. The questionnaire has been revised to align with updated medication competencies. The factor structure or dimensionality of the questionnaires has not been examined.AimTo examine the psychometric properties of the Preparedness for Medication Administration (Revised) Questionnaire.MethodData from a previous study were used to determine the psychometric properties of the Preparedness for Medication Administration (Revised) Questionnaire. Three new items were added to the revised questionnaire, and the focus shifted from the oral route of medication administration. An exploratory factor analysis was conducted to assess the reliability and dimensionality of the revised questionnaire, using principal axis factoring and Oblique rotation on the 20 items.ResultsTwo hundred fourteen final-year undergraduate nursing students completed the questionnaire; the Kaiser–Meyer–Olkin measure confirmed sampling adequacy (.96) and Bartlett's test of sphericity χ2(214) 3003.534 p < .001 adequate sample size-to-variable ratio and inspection of the correlation matrix for loadings > 0.30. The 20 items produced a 2-factor solution, which was also confirmed by parallel analysis, with the deletion of 4 items not meeting item loadings of > 0.4. The final revised version of the questionnaire titled the Preparedness for Medication Administration Revision2 (PMAR2) contained 16 items loading onto one of the 2 factors titled Clinical Reasoning and Confidence to Practice Safely. Cronbach alpha coefficients for the factors were .89 to .95, respectively.ConclusionThis research provides information for a psychometrically sound tool to assess students' preparedness for medication administration once they graduate and become independent practitioners.

Development and Psychometric Properties of a Tool Related to the Adoption of Desirable Behaviors in the Consumption of Sugar-sweetened Beverages in Children Based on the Social Cognitive Theory

Background Consumption of sugar-sweetened beverages is associated with chronic diseases such as diabetes and cardiovascular disorders and other severe negative health consequences and is one of the challenging issues in the field of nutrition in today's societies. This study was conducted with the aim of designing a psychometric questionnaire in relation to the consumption behavior of sugar-sweetened drinks in children. Methods In this cross-sectional research, 607 students were selected and included in the study by multi-stage cluster sampling from the first-year secondary schools covered by the Urmia Department of Education. Waltz's method was used to design the questionnaire, and based on a targeted review of the literature and questionnaires related to nutrition behavior, an initial questionnaire with 51 items was designed. After confirming the face and content validity of the questionnaire by 15 members of the expert panel, construct validity steps were performed using exploratory factor analysis. Finally, the internal reliability of the questionnaire was determined by calculating Cronbach's alpha. Results The first version of the questionnaire was designed with 51 items and all the items were retained in the psychometric process during content validity. The content validity index and ratio were calculated to be higher than 0.79 and 0.6, respectively. Based on the exploratory factor analysis, the number of items in the questionnaire remained at 51, and the dimensions of the questionnaire were categorized into 6 factors: perceived barriers, self-efficacy, self-regulation, social support, preventive behaviors, and reinforcing behaviors, with a predictive power of 56,261 and in repeating the exploratory factor analysis for items with a different nature from other factors, 3 separate factors were identified: the physical health dimension of outcome expectations, negative outcome expectations, and positive outcome expectations with a predictive power of 54.667. The internal reliability of the questionnaire items was accepted and confirmed with Cronbach's alpha coefficient above 0.70. Conclusion The final questionnaire with 51 items has the ability to be used by various researchers due to the strength of the factorial structure and suitable psychometric properties.

Quick Self-Compassion: Italian Validation, Network Analysis, Item Response Theory Analysis, and Correlates of the Self-Compassion Scale Short Form

Abstract Objectives This study aimed to test the factorial structure and gender invariance of the Self-Compassion Scale Short Form (SCS-SF) in the Italian context (Aim 1), underlying relationships among SCS-SF items (Aim 2), questionnaire performance of SCS-SF (Aim 3), and correlations of SCS-SF (and its subscales) with cognitive, affective, and well-being variables (Aim 4). Method Six questionnaires including the SCS-SF and different correlates were respectively administered to six Italian convenience samples (total n = 2068). We performed confirmatory (ULS estimator) factor analysis (Aim 1), exploratory graph analysis and network analysis (Aim 2), multidimensional item response theory (IRT) analyses (Aim 3), and correlational analyses (Aim 4). We tested Aims 1–3 on the global sample and Aim 4 on the six samples separately. Results We found a two-factor (hierarchical) solution — which also had strict gender invariance — identifying Compassionate and Uncompassionate Self-Responding (CSR and USR), respectively composed of positive and negative items, while three- and six-factor structures did not hold (Aim 1). The SCS-SF network was structured into the CSR and USR clusters (Aim 2). CSR and — especially — USR had a satisfactory performance in terms of IRT discrimination and information (Aim 3). Correlational analyses supported the convergent and discriminant validity of the scales, showing the cognitive and emotion-regulation strategies associated with self-compassion and confirming that CSR and USR have slightly different correlates (Aim 4). Conclusions The Italian SCS-SF and its CSR and USR subscales are valid instruments. Future research and interventions can employ CSR and USR to assess different nuances of self-kindness and self-criticism.

The Depression, Anxiety, Stress Scales-21: Principal component analysis and evaluation of abbreviated versions in young adults with temporomandibular disorders.

The Depression, Anxiety, Stress Scales-21 (DASS-21) contain three subscales measuring depression, anxiety, and stress. Several abbreviated DASS-21 versions have been developed, demonstrating better clinical utility and measurement properties than the original instrument. This study explored the factor structure of various abbreviated DASS-21 versions and identified/validated the optimal one for assessing young adults with temporomandibular disorders (TMDs). A total of 974 university-attending young adults were recruited in two waves (wave 1: 519; wave 2: 455). Demographic information, the DASS-21, and quintessence five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs were collected. Principal component analysis (PCA) was employed to condense the DASS-21 (wave 1 data), while confirmatory factor analysis (CFA) was used to determine maximum likelihood estimates and compare different abbreviated DASS-21 versions (wave 2 data). Known-group, concurrent (criterion) validity and reliability were subsequently evaluated. The mean age of the study participants was 21 (SD = 0.1) years and 80.4% were women. Twelve DASS-21 items were identified from the PCA. However, the Korean DASS-12 provided the best-fit model (χ2/df = 2.07, CFI = 0.975, TLI = 0.960, RMSEA = 0.049, SRMR = 0.033) among the seven abbreviated versions in the CFA. The Korean DASS-12 showed good known-group and concurrent (rs = 0.959) validity and reliability when contrasted to the DASS-21. The Korean DASS-12 possessed a good fit, known-group, as well as concurrent (criterion) validity and reliability, and was the best abbreviated DASS-21 version for screening young adults with TMD symptoms for psychological distress.

Psychometric properties of an instrument measuring monkeypox knowledge, perception, and beliefs of health threat in health science students in a middle-income country

Objective This study aimed to establish the factor structure and reliability of the evaluation instrument measuring monkeypox (Mpox) knowledge, perception and beliefs of health threat in students of the health area in two universities of Peru during 2022. Methods The methodology used was psychometric in nature. The study variable on knowledge of Mpox was based on the instrument made by Ricco et al., carried out with health professionals, adjusted to Peru and administered to 416 students. Results The results showed adequate goodness-of-fit indicators with RMSEA and SRMR coefficients lower than 0.08 and a TLI lower than 0.90 and adequate reliability values for knowledge of Mpox (KR20=0.70 and α=0.73), with the perception of health threats being the one with the highest reliability (α=0.88 and Ω=0.89). Conclusions Having instruments that accurately reflect the knowledge, perception and beliefs of health students will make it possible to contribute significantly to the prevention, control and management of this disease and, at the same time, be prepared to address other challenges of public health in the future.

Exploring the Unidimensionality of the GAD-7 for South African First Responders: Evidence from Multiple Psychometric Approaches

Generalized Anxiety Disorder (GAD) is a prevalent mental health condition and the GAD-7 is widely used as a screening tool and measure of GAD severity. However, research has yielded conflicting findings regarding the factor structure of the instrument, with some studies supporting a unidimensional interpretation while others suggest a two-factor solution. These inconsistencies highlight the importance of validating the GAD-7 across diverse populations. This study aimed to assess the psychometric properties and factor structure of the GAD-7 among South African first responders (n = 429). Participants completed a demographic questionnaire along with the GAD-7, the Patient Health Questionnaire, the Post-Traumatic Stress Disorder Checklist, and subscales from the Maslach Burnout Inventory, namely Emotional Exhaustion and Depersonalization. The dimensionality of the GAD-7 was examined using Mokken Scale Analysis (MSA), parallel analysis, and Confirmatory Factor Analysis (CFA) with a Schmid-Leiman transformation. Results supported the unidimensionality of the GAD-7. MSA indicated that all items were loaded onto a single scale, with strong inter-item correlations and a high H-coefficient. The parallel analysis confirmed that only one factor was necessary, and the Schmid-Leiman transformation extracted a general factor accounting for 84% of the item variance. Furthermore, the reliability of the GAD-7 was excellent, with alpha and omega coefficients exceeding 0.90, indicating high internal consistency. The strong reliability and validity of the GAD-7 in this study reinforce its utility as a reliable tool for assessing generalized anxiety in a non-clinical setting.

Development of a novel instrument to measure Japanese psychiatric nurses' technological competency as caring in nursing.

To effectively advance person-centered care (PCC) practice, it is important to equip healthcare providers with person-centered values and beliefs while simultaneously transforming their work environment to align with PCC. Thus, instruments to measure caring practice status in nursing competency for psychiatric-specific behavioral limitations, ethico-moral behavior, technology use, and PCC need to be developed. This study developed the Technological Competency as Caring in Psychiatric Nursing Instrument (TCCNPNI) to measure practice status and test its content and construct validity. Five different phases were followed: 1) Literature Review; 2) Operational definition of the construct and development of items; 3) Two-round Delphi method; 4) Validity measure; and 5) Reliability measure. The online survey was conducted in 2024. The developed instrument comprises 22 items with a 4-factor structure: competency to practice caring and person-centered care (Factor 1); competency to recognize and respond to ethical issues in psychiatry (Factor 2); competency to utilize technology in psychiatry (Factor 3); and competence to practice care for the preservation of human dignity and shared decision making (Factor 4). Cronbach's alpha for the entire scale was 0.864, while that for factors 1-4 was 0.911, 0.814, 0.773, and 0.64, respectively. Cumulatively, these four factors contributed 49.6% and explained nearly 50% of the total data. Item-total correlation values were 0.6 or higher among factors 1-3. However, factor 4, for which items were Q30, Q33, Q34, and Q35 (r = 0.03, 0.04, 0.21, 0.11, respectively), were inverted items and had low I-T correlation values. These low correlations suggest that these items capture different concepts. The developed TCCNPNI allows for the measurement of the practice of nursing as caring in psychiatry, the state of ethico-moral behavior, and the practice status of technological competency as caring in psychiatric nursing. This study demonstrated satisfactorily and efficiently evaluated the practice status of technological competency in psychiatric nurses' caring. Measuring technological competency as caring in psychiatric nursing can be an important adjunct for in-service education in psychiatric hospitals or formalized nursing education in nursing universities.

Psychometric Properties of Chinese Version of the Multiple Intelligence Scale (MIS) Among Older Adults: Rasch Analysis and Confirmatory Factor Analysis.

A cross-sectional study design using convenience sampling was conducted among 200 community-dwelling participants aged 65 years or older. The Rasch analyses showed that the MIS had good structure validity and unidimensionality. Among various CFA models testing the MIS factor structure, exploratory structural equation modelling performed the best given its parsimonious and excellent fit indices. The MIS can be used among older adults in a culturally-fair way for understanding their multiple intelligences. Using the MIS, healthcare providers could encourage older people to assess their own strengths and weaknesses of intelligence. The results suggest that more research on older adults' MI is needed to tailor bespoke therapeutic programs to individual needs in community settings.

Assessing levels of flourishing: Diener’s flourishing scale reveals greater insights into low flourishing in a Hungarian sample

Abstract The present study seeks to validate Diener’s flourishing scale in the context of a sizable Hungarian sample and explore its informative characteristics across diverse score ranges to discern the levels of flourishing accurately captured by the instrument. A large cross-sectional sample (N = 1540) was used for the study. The analyses, including Confirmatory Factor Analysis (CFA), established model fit and invariance across distinct groups (sex and education), validating the scale’s construct validity. Correlative validities were assessed by examining associations with Savoring and PERMA constructs, along with their subscales. Additionally, Item Response Theory (IRT) was used to explore the latent relationship between flourishing and its constituent items. The study strongly supported the one-dimensional model of flourishing by confirming its factor structure within the Hungarian context. Measurement invariance across gender and education was established, ensuring consistent measurement across diverse groups. The Flourishing Scale displayed robust validity, correlating significantly with Savoring and PERMA constructs (r =|0.39| to|0.71|). Nevertheless, the IRT analysis revealed limitations for scores above the mean, indicating higher standard errors and reduced precision in assessing flourishing levels, particularly for respondents with elevated scores. The Diener’s flourishing scale demonstrated robust fit and exhibited commendable reliability and validity within the extensive Hungarian sample under investigation. However, the IRT findings underscored the need for cautious interpretation when gauging higher levels of flourishing, as the scale’s precision may be somewhat compromised in this range.

Measuring psychological flexibility and inflexibility: further psychometric evidence of the Multidimensional Psychological Flexibility Inventory short form (MPFI-24) in Spanish population

Abstract The Multidimensional Psychological Flexibility Inventory (MPFI) is a recently developed measure of psychological flexibility and inflexibility (PF and PI) based on the Hexaflex/Inflexahex Model. The aim of this article was to assess the factorial structure, reliability, and convergent and criterion validity of the MPFI-24 in a sample from Spain. The MPFI-24 was tested in a sample of 508 university students (Study 1). Items comprising the acceptance and Experiential Avoidance (EA) subscales were rewritten and tested in a sample of 406 university students (Study 2). Participants completed online cross-sectional surveys including the Spanish MPFI-24, and measures of PF, PI, and mental health. Confirmatory factor analysis showed a six-component first-order factor structure for PF and for PI. The MPFI-24 demonstrated acceptable internal consistency, temporal stability, and convergent and criterion validity. The MPFI-24 is a promising tool. Potential areas for improvement of the measure are discussed.

Testing a Multidimensional Factor Structure of the Self-Control Scale.

The Self-Control Scale (SCS) is one of the most widely used measures in the clinical, personality, and social psychology fields. It is often treated as unidimensional, even though no research supports such a unidimensional factor structure. We tested the factor structure in an undergraduate sample as well as a community sample used for additional confirmatory analyses. Factors from the best-fitting confirmatory models were correlated with putatively related and distinct constructs to assess their (dis)similarities. Consistent with hypotheses, the best-fitting factor structure consisted of multiple, correlated factors; however, none of the factor solutions met pre-specified fit criteria. Several additional analyses were conducted beyond the preregistered analyses to find a reasonably fitting factor solution. Ultimately, study findings support a two-factor solution using the items of the Brief Self-Control Scale. Results are discussed for the full 36-item scale as well as the brief, 13-item scale. We conclude with lessons learned from a Registered Report focused on factor analysis.

Dimensionality and Psychometric Properties of the Chinese Version of the Psychological Capital Questionnaire Short Form (CPCQ-12): Is PsyCap a Single-Factor, Four-Factor, Higher-Order, or Bifactor Construct?

Psychological capital (PsyCap) is a personal resource that enables employees to persevere in pursuing goals, display confidence, recover from setbacks, and maintain positive outlooks. The Psychological Capital Questionnaire (PCQ) is the standard measure for assessing PsyCap, and its short form (PCQ-12) has gained popularity. However, limited evidence exists regarding the validity and reliability of the PCQ-12, resulting in inconsistencies among studies concerning its factor structure. This is particularly notable for the Chinese version, where extensive research has been conducted without thorough investigation into its psychometric properties. This study investigated the dimensionality and psychometric properties of the Chinese version of the Psychological Capital Questionnaire (CPCQ-12) using a diverse working sample (n = 991) from various occupations and industries in Hong Kong, China. The results revealed that the bifactor CFA model, comprising a general PsyCap factor and four specific factors (i.e., hope, efficacy, resilience, and optimism), demonstrated superior fit compared to the single-factor, four-factor, and higher-order models. Strong measurement invariance was observed across occupations. Evidence supporting reliability and criterion-related validity was also obtained. However, item 8 did not load significantly on its resilience factor, suggesting that this item should be excluded if the resilience subscale is used. These findings suggest that the CPCQ-12 is a valid and reliable measure of PsyCap for Chinese working populations, while also highlighting the need for conceptual, item-level, and statistical refinements.

Development and validation of a questionnaire for table tennis teaching in physical education

This study aimed to validate the “Racquet Sports Attitude Scale (RSAS)” questionnaire intended for the educational field. The RSAS is a Spanish instrument developed using the Delphi method and consists of 42 questions divided into five subsections benefits of table tennis (TT), facilitators for the application of TT, barriers to applying tennis table in physical education (PE), difficulties in applying the tennis table as a PE content and positive attitude toward racket sports), designed to evaluate the use and impact of the practice of the racket sports, in particular TT, among PE teachers. The semantic validation process involved a panel of experts (n = 16), followed by an evaluation carried out by a group of teachers from various secondary schools (n = 20). Three studies were conducted, the first of which was descriptive, comparative and correlational, to establish the data’s sociodemographic characteristics. The second was an exploratory factor analysis to confirm the number of dimensions of the questionnaire and its reliability and validity. The last study was a confirmatory factor analysis (to establish the final number of items and their structure. The ordinal alpha values ranged from 0.65 to 0.72, obtaining an average value of 0.70, indicating coherence between the measurement of the items. Chi-square values (X2 = 197.383; p &amp;lt; 0.001; CFI = 0.934; TLI = 0.923 and RMSEA = 0.030), showed that the original 5-factor model and 21 final items prevailed over the one-factor model, obtaining values &amp;gt;0.90. On the other hand, the validation results indicated that the factor structure of the RSAS scale was able to explain 46.72% of the variance (F1 = 13.93%; F2 = 10.97%; F3 = 8.57%; F4 = 6.85%; F5 = 6.38). It can be concluded that the structure of the RSAS is fully confirmed by the statistical analyses derived from the different models of structured equations and confirmatory factor analysis, suggesting that the validated model optimally addresses the data provided and contributes to the validation of the questionnaire under study.

Development and Validation of the Satisfaction with the Intervention for Intimate Partner Violence Perpetrators Scale (SIIPVS)

Abstract Purpose Although research in the intimate partner violence (IPV) field has significantly advanced in recent decades, important challenges remain in intervention effectiveness terms. Some authors point out that satisfaction with intervention could be an indicator of effectiveness. However, this variable has not been thoroughly explored in the scientific literature. This study aimed to develop and validate a scale to measure the satisfaction with the intervention of participants attending an intervention program for IPV perpetrators. Methods A panel of experts developed the Satisfaction with the Intervention for Intimate Partner Violence Perpetrators Scale (SIIPVS) items. A sample of 646 male perpetrators was employed. Exploratory and confirmatory factor analyses, and a reliability analysis, were conducted. Scale validity was examined in relation to other relevant variables to the intervention, such as recidivism, working alliance, motivation to change and state of change. Results The findings indicate that the factor structure with the best fit consisted of three factors: Satisfaction with the facilitators and program delivery, Satisfaction with the learning-process, and Satisfaction with the peer group. All the factors demonstrated adequate internal consistency. Participant satisfaction with various intervention elements was associated with the key variables of these interventions. Conclusions The validation analysis results indicated that the SIIPVS is a suitable scale to analyze the satisfaction of the participants attending an intervention program for IPV perpetrators due to its adequate psychometric properties. Understanding participant satisfaction could provide a more comprehensive approach to evaluate the effectiveness of these interventions.

Enhancing Patient Safety Education: Cross-Cultural Validation of the APSQ-III in Brazilian Healthcare Students

Background: This study aimed to adapt and validate the Attitudes to Patient Safety Questionnaire (APSQ-III) for Brazilian Portuguese and to compare patient safety attitudes between medical and nursing students. Given the critical role of assessing safety attitudes in shaping future healthcare professionals, this research addresses a significant gap in the Brazilian educational context. Materials and Methods: The cross-cultural adaptation process adhered to the guidelines of for the Process of Cross-Cultural Adaptation of Self-Report Measures, encompassing translation, synthesis, back-translation, and expert committee evaluation. The adapted APSQ-III was administered to a sample of 423 undergraduate students from medicine and nursing courses. Confirmatory factor analysis (CFA) was conducted to verify the factor structure, while reliability was assessed using Cronbach’s alpha, McDonald’s omega, and composite reliability measures. Results: The CFA supported an acceptable fit for the nine-factor model with 26 items, following the exclusion of 4 items (χ2/df = 1.92; CFI = 0.90; TLI = 0.89; RMSEA = 0.05; SRMR = 0.07). Factor loadings ranged from 0.30 to 0.82, with satisfactory reliability indices, except for factors 4 (α = 0.47; ω = 0.48) and 9 (α = 0.54; ω = 0.54). Significant differences were discovered between medical and nursing students in four factors, and gender differences were noted in five items, highlighting the diverse perceptions of patient safety across these groups. Conclusions: The Brazilian version of the APSQ-III demonstrated adequate validity and reliability for seven out of the nine original factors. It is recommended to use the scale with modifications, such as developing a reduced version excluding factors with low reliability, to enhance its applicability. This study contributes to advancing patient safety research and education in Brazil, providing a robust tool for evaluating and improving safety attitudes among healthcare students. Future research should focus on refining the instrument and exploring its application in diverse healthcare educational settings across Brazil.

Nonlinear forecasting with many predictors using mixed data sampling kernel ridge regression models

Abstract Policy institutes such as central banks need accurate forecasts of key measures of economic activity to design stabilization policies that reduce the severity of economic fluctuations. Therefore, this paper develops a kernel ridge regression estimator in a mixed data sampling framework. Kernel ridge regression can handle many predictors with a nonlinear relationship to the target variable. Consequently, it has potential to improve the currently used principal component-based methods when the economic data follow a nonlinear factor structure. In a Monte Carlo study, we show that the kernel ridge regression approach is superior in terms of mean square error and is more robust than principal component-based methods to different nonlinear data generating processes. By using a dataset consisting of 24 economic indicators, we forecast Swedish gross domestic production. The results confirm the superiority of the kernel ridge regression approach. Therefore, we suggest that policy institutes consider the use of kernel-based approaches when forecasting key measures of economic activity.

P0362 Bowel urgency in inflammatory bowel disease: The URGENT index

Abstract Background Bowel urgency is commonly defined as the sudden need to rush to the bathroom to empty one’s bowel. In a systematic review including 321 studies evaluating bowel urgency, definition of bowel urgency was heterogeneous (1). In most of these studies, non-validated questionnaires, based on subjective responses of the patients, were used. The objective of this study were to develop the URGENT index, an IBD-specific bowel urgency index, and to evaluate correlation between the URGENT index and the Urgency Numeric Rating Scale (UNRS). Methods URGENT-1 was a cross-sectional, multicenter study with prospective inclusions of IBD patients and with an optional follow-up for a subset of patients. A stratification on the type of IBD was performed. The components of the URGENT index were based on variables describing in systematic review and expert opinion. All the symptoms potentially associated with bowel urgency were collected, and assessed with a 10-point visual analog scale. Results The content validity of the symptoms potentially associated with bowel urgency was tested by five experts. Face validity of the selected items was checked for clarity, comprehension, and ease of response with 20 patients. Then data corresponding to the selected items were collected. The overall Cronbach’s alpha coefficient was 0.972. We systematically removed items based on their individual impact on the overall Cronbach’s Alpha. Three main factors explained most of the variance (87.9%): immediate urgency and action, ability to delay to go to toilets, and emotional and behavioral responses to urgency. There was no difference in gender and IBD type in the distribution in the factorial structure. To construct the index, we extracted the loadings from the PCA results and identified significant loadings with a threshold of 0.6. Next, we calculated the row means for these significant items to create subscale scores for each component. These scores were then weighted by the variance explained by each component. The weights were normalized, and the final index, named URGENT index, was calculated as a weighted sum of the subscale scores. A sample of 40 patients, who were considered as stable, were studied to evaluate the test-retest reliability after a 3- week-period. Consistency of the URGENT index with the UNRS was tested using Spearman correlation test (0.77). Overall, the ICC values indicated good to excellent reliability across different models. Each index proposal will be tested prospectively. Conclusion This study developed an IBD-specific bowel urgency index. This will allow to have a homogeneous and standardized definition of bowel urgency, measure the effectiveness of treatments, and systematically assess this symptom in clinical practice for IBD patients. References Caron B, Ghosh S, Danese S, Peyrin-Biroulet L. Identifying, Understanding, and Managing Fecal Urgency in Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2023 Jun;21(6):1403-1413.e27. doi: 10.1016/j.cgh.2023.02.029. Epub 2023 Mar 9. PMID: 36906079.

P0508 Food-related quality of life is worse in Crohn’s disease, stricturing disease and those with a surgical history: development and validation of the FR-QoL-29-Dutch (Flemish) questionnaire

Abstract Background The food-related quality of life (FRQoL) questionnaire was developed in inflammatory bowel disease (IBD) to evaluate the impact of diet on a person’s quality of life (1-3). FRQoL is reduced in IBD and associates with a reduced intake of key nutrients (1). Since Belgian studies are lacking, we aimed to translate and validate the FR-QoL-29 into Dutch and to investigate FRQoL and factors associated with it in a Belgian IBD population. Methods The original FR-QoL-29 was translated from English to Dutch and adapted to the Flemish setting using the forward-backward method. The translated instrument was reviewed by the Flemish patient organisation to produce the final FR-QoL-29-Dutch (Flemish) questionnaire. All IBD patients in an outpatient setting were eligible and recruited from October 2023 to July 2024. The FR-QoL-29 Dutch (Flemish) was completed alongside symptoms and disease-specific QoL questionnaires, and routine clinical and biochemical data were collected. Exploratory factor analysis (EFA) with promax rotation assessed the underlying factor structure. Reliability measures (internal consistency, test-retest reliability) were evaluated. Pearson correlations examined relationships between FR-QoL-29 scores and disease severity (PRO-2, Manitoba IBD Index) and IBD-related disability (IBD-disk). Correlation between FR-QoL-29 scores and clinical parameters were analysed using independent samples t-tests and Welch’s ANOVA with Tukey post-hoc tests as appropriate. Results 312 participants completed the FR-QoL-29-Dutch (Flemish), with 31 (9.9%) undertaking a retest within two weeks (Table 1). EFA revealed a one-factor structure explaining 55% of the variance. The FR-QoL-29-Dutch (Flemish) showed excellent internal consistency (Cronbach’s α = 0.97) and very good test-retest reliability (intraclass correlation = 0.94 [95% CI: 0.88-0.97]). Mean (SD) scores were 86.34 (24.6). Lower FR-QoL-29 scores were significantly correlated with increased disease activity (Manitoba: r=−0.49; PRO-2 for Crohn’s disease (CD): r=−0.48; PRO-2 for UC: r=−0.38) and IBD-related disability (r=−0.54; all p&amp;lt;0.001). FR-QoL-29 scores were lower in CD (p=0.01) and those who previously received surgery (p&amp;lt;0.0001, Figure 1). Likewise, patients with stricturing CD (Montreal B2) had significantly lower FR-QoL-29 scores compared to B1 and B3 (all p&amp;lt;0.01). There were no differences when using advanced treatments or neuromodulators. Conclusion The FR-QoL-29-Dutch (Flemish) is a valid and reliable tool to assess FRQoL in IBD patients in the Flemish setting. FR-QoL-29 correlates with disease activity and IBD-related disability. CD patients, those with stricturing disease and those who underwent surgery have significantly lower FRQoL and should be targeted for support.