Fit Indices Research Articles

Psychometric evaluation of the Chinese version of the Academic Resilience Scale-30 (C-ARS-30) in college students.

Amidst the expansion of student enrollment in higher education, the well-being and retention rates of students have emerged as important concerns. Resilience, especially academic resilience, a multidimensional construct that can lead to academic success in adversity, is pivotal in enabling students to successfully cope with academic challenges. While the Academic Resilience Scale-30 (ARS-30) has been validated as an effective instrument in various languages, its applicability for Chinese students in higher education remains unexplored. This study aims to translate and validate the ARS-30 in Chinese, assessing its reliability and validity among Chinese college students in higher education. A convenience sample of 1,542 students participated in this study. The inventory included the demographic form, Chinese version of ARS-30 (C-ARS-30), 10-item Connor Davidson Resilience Scale (CD-RISC-10), and General Self-Efficacy Scale (GSES). The assessment of validity was conducted by analyzing content validity, construct validity, convergent and discriminant validity, as well as criterion-related validity. Construct validity was evaluated through Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA) and Exploratory Structural Equation Modeling (ESEM). Reliability analysis was performed using Cronbach's alpha and test-retest reliability. The C-ARS-30 demonstrated commendable content validity, with the CVI value of items ranging from 0.833 to 1.000, and a total scale CVI of 0.986. ESEM analysis revealed a solid four-factor structure, maintaining the scale's 30 items with excellent fit indices (χ2/df = 2.647, CFI = 0.937, TLI = 0.915, RMSEA = 0.057, SRMR = 0.027). The total score of C-ARS-30 exhibited positive correlations with the CD-RISC-10 (r = 0.542) and the GSES (r = 0.488). The scale demonstrated high internal consistency (Cronbach's α = 0.930) and test-retest reliability (0.794, p < 0.01). The C-ARS-30 is a reliable and valid instrument for assessing academic resilience among Chinese college students, offering a valuable tool for educational and psychological evaluations.

Optimizing young tennis players' development: Exploring the impact of emerging technologies on training effectiveness and technical skills acquisition.

The research analyzed the effect of weekly training plans, physical training frequency, AI-powered coaching systems, virtual reality (VR) training environments, wearable sensors on developing technical tennis skills, with and personalized learning as a mediator. It adopted a quantitative survey method, using primary data from 374 young tennis players. The model fitness was evaluated using confirmatory factor analysis (CFA), while the hypotheses were evaluated using structural equation modeling (SEM). The model fitness was confirmed through CFA, demonstrating high fit indices: CFI = 0.924, TLI = 0.913, IFI = 0.924, RMSEA = 0.057, and SRMR = 0.041, indicating a robust model fit. Hypotheses testing revealed that physical training frequency (β = 0.198, p = 0.000), AI-powered coaching systems (β = 0.349, p = 0.000), virtual reality training environments (β = 0.476, p = 0.000), and wearable sensors (β = 0.171, p = 0.000) significantly influenced technical skills acquisition. In contrast, the weekly training plan (β = 0.024, p = 0.834) and personalized learning (β = -0.045, p = 0.81) did not have a significant effect. Mediation analysis revealed that personalized learning was not a significant mediator between training methods/technologies and acquiring technical abilities. The results revealed that physical training frequency, AI-powered coaching systems, virtual reality training environments, and wearable sensors significantly influenced technical skills acquisition. However, personalized learning did not have a significant mediation effect. The study recommended that young tennis players' organizations and stakeholders consider investing in emerging technologies and training methods. Effective training should be given to coaches on effectively integrating emerging technologies into coaching regimens and practices.

Adaptation and validation of the evidence-based practice profile (EBP2) questionnaire in a Norwegian primary healthcare setting

BackgroundAccess to valid and reliable instruments is essential in the field of implementation science, where the measurement of factors associated with healthcare professionals’ uptake of EBP is central. The Norwegian version of the Evidence-based practice profile questionnaire (EBP2-N) measures EBP constructs, such as EBP knowledge, confidence, attitudes, and behavior. Despite its potential utility, the EBP2-N requires further validation before being used in a cross-sectional survey targeting different healthcare professionals in Norwegian primary healthcare. This study assessed the content validity, construct validity, and internal consistency of the EBP2-N among Norwegian primary healthcare professionals.MethodsTo evaluate the content validity of the EBP2-N, we conducted qualitative individual interviews with eight healthcare professionals in primary healthcare from different disciplines. Qualitative data was analyzed using the “text summary” model, followed by panel group discussions, minor linguistic changes, and a pilot test of the revised version. To evaluate construct validity (structural validity) and internal consistency, we used data from a web-based cross-sectional survey among nurses, assistant nurses, physical therapists, occupational therapists, medical doctors, and other professionals (n = 313). Structural validity was tested using a confirmatory factor analysis (CFA) on the original five-factor structure, and Cronbach’s alpha was calculated to assess internal consistency.ResultsThe qualitative interviews with primary healthcare professionals indicated that the content of the EBP2-N was perceived to reflect the constructs intended to be measured by the instrument. However, interviews revealed concerns regarding the formulation of some items, leading to minor linguistic revisions. In addition, several participants expressed that some of the most specific research terms in the terminology domain felt less relevant to them in clinical practice. CFA results exposed partial alignment with the original five-factor model, with the following model fit indices: CFI = 0.749, RMSEA = 0.074, and SRMR = 0.075. Cronbach’s alphas ranged between 0.82 and 0.95 for all domains except for the Sympathy domain (0.69), indicating good internal consistency in four out of five domains.ConclusionThe EBP2-N is a suitable instrument for measuring Norwegian primary healthcare professionals’ EBP knowledge, attitudes, confidence, and behavior. Although EBP2-N seems to be an adequate instrument in its current form, we recommend that future research focuses on further assessing the factor structure, evaluating the relevance of the items, and the number of items needed.RegistrationRetrospectively registered (prior to data analysis) in OSF Preregistration. Registration DOI: https://doi.org/10.17605/OSF.IO/428RP.

On the Estimation of Fit Indices for the Structural Part of a Model

When a researcher proposes an SEM model to explain the dynamics among some latent variables, the real question in model evaluation is the fit of the model’s structural part. A composite index that lumps the fit of the structural part and measurement part does not directly address that question. The need for more attention to structural-level fit has been noted for a long time, but the literature has been limited to conceptual issues such as how to define the structural-level RMSEA or CFI. How to estimate those structural-level fit indices, however, have been overlooked. Traditional estimation methods for composite-fit RMSEA and CFI are not applicable to structural-level fit indices, even if data are complete and normally distributed. In this article, we give correct point estimators and confidence intervals for structural-level RMSEA and CFI. Simulation results suggest that the new methods have satisfactory performance in realistic situations.

Does the Bayley-4 measure the same constructs across girls and boys and infants, toddlers, and preschoolers?

This study tested the assumption that the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4) functions similarly for boys and girls and for four age groups. The Bayley-4 American norming sample of 1,700 children ages 0-42 months (3.5 years) was used, which included 50% boys and girls. Fifty-three percent of the children identified as White, 22.1% as Hispanic, 12.5% as Black, 8.5% as other, and 4.0% as Asian. A confirmatory factor analysis demonstrated the three-factor structure of cognitive, language, and motor abilities fit the data well (comparative fit index = .99, root-mean-square of error of approximation = .08, standardized root-mean-square residual = .02) and fit significantly better than the two- and one-factor models. The correlations between the latent factors were moderate (r = .73) to large sized (r = .81). Measurement and structural invariance were tested for boys and girls and four age groups (0-5, 6-13, 14-25, and 26-42 months). Residual invariance was supported for girls and boys, and intercept invariance was supported for the four age groups. The measurement invariance results suggest the Bayley-4 is not biased toward these gender and age groups, and group comparisons and decision making can be made with the Bayley-4 scores. Structural invariance findings suggested some differences for gender and age groups. The relations between the cognitive, language, and motor factors and factor variances were equal across girls and boys but differed significantly across the four age groups. Girls scored significantly higher on the three latent means, but these differences were small to negligible. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Optimizing Oxford Shoulder Scores with computerized adaptive testing reduces redundancy while maintaining precision.

The Oxford Shoulder Score (OSS) is a 12-item measure commonly used for the assessment of shoulder surgeries. This study explores whether computerized adaptive testing (CAT) provides a shortened, individually tailored questionnaire while maintaining test accuracy. A total of 16,238 preoperative OSS were available in the National Joint Registry (NJR) for England, Wales, Northern Ireland, the Isle of Man, and the States of Guernsey dataset (April 2012 to April 2022). Prior to CAT, the foundational item response theory (IRT) assumptions of unidimensionality, monotonicity, and local independence were established. CAT compared sequential item selection with stopping criteria set at standard error (SE) < 0.32 and SE < 0.45 (equivalent to reliability coefficients of 0.90 and 0.80) to full-length patient-reported outcome measure (PROM) precision. Confirmatory factor analysis (CFA) for unidimensionality exhibited satisfactory fit with root mean square standardized residual (RSMSR) of 0.06 (cut-off ≤ 0.08) but not with comparative fit index (CFI) of 0.85 or Tucker-Lewis index (TLI) of 0.82 (cut-off > 0.90). Monotonicity, measured by H value, yielded 0.482, signifying good monotonic trends. Local independence was generally met, with Yen's Q3 statistic > 0.2 for most items. The median item count for completing the CAT simulation with a SE of 0.32 was 3 (IQR 3 to 12), while for a SE of 0.45 it was 2 (IQR 2 to 6). This constituted only 25% and 16%, respectively, when compared to the 12-item full-length questionnaire. Calibrating IRT for the OSS has resulted in the development of an efficient and shortened CAT while maintaining accuracy and reliability. Through the reduction of redundant items and implementation of a standardized measurement scale, our study highlights a promising approach to alleviate time burden and potentially enhance compliance with these widely used outcome measures.

Cultural adaptation and validation of the knee injury and osteoarthritis outcome score into Sinhala language in patients with primary knee osteoarthritis: a cross-sectional study

BackgroundKnee Injury and Osteoarthritis Outcome Score (KOOS) scale is a patient-reported outcome measurement tool. It evaluates both short- and long-term consequences of knee injury and primary osteoarthritis. This study aims to translate and validate the KOOS scale for a Sinhala-speaking Sri Lankan population.MethodsA cross sectional study was conducted in three hospitals. Four hundred and fifteen patients comprising 185 males and 227 females (3 subjects did not reveal their gender) with knee osteoarthritis (KOA) participated in the study. Seventy nine participants without KOA were recruited as controls. The functionality and quality of life level in patients and healthy participants were assessed using translated versions of the KOOS and Short Form-36 (SF-36) scales. Internal consistency of the instrument was assessed by Cronbach alpha. Construct validity and test-retest reliability were examined using the Intraclass Correlation Coefficient (ICC). Confirmatory Factor Analysis (CFA) was used to assess factorial validity.ResultsThe mean age (± sd) of the KOA subjects was 54.9 (± 9.2) years and for the control group was 49.2 (± 8.0) years. Majority of the respondents were female and Sinhalese in both groups. Internal consistency reliability was high (Cronbach’s alpha values ≥ 0.70). The test–retest reliability was excellent with the intraclass correlation coefficient for all subscales being above 0.90. Construct validity was assessed by the magnitude of the correlation coefficient between KOOS and SF-36 subscale scores. KOOS Pain scale moderately correlated with SF-36 bodily pain (Pearson’s r = 0.41). SF-36 physical function scores had a weak positive correlation with all KOOS subscales and SF-36 emotional wellbeing was not significantly correlated with KOOS Quality of Life (QoL) subscale. A five-factor Confirmatory Factor Analysis (CFA) model yielded a Comparative Fit Index (CFI) = 0.950, Tucker Lewis Index (TLI) = 0.946, Root Mean Square Error of Approximation (RMSEA) = 0.082 and Standardised Root Mean squared Residual (SRMR) = 0.072.ConclusionThe Sinhala translation of the KOOS scale is a reliable and valid instrument to assess KOA in a Sinhala-speaking Sri Lankan population. Studies to assess its use as a scale to evaluate responsiveness are recommended.

Validation of the athletic mental energy scale for Chinese school-age adolescents

Mental energy is an important factor in many domains, including athletic performance. The athletic mental energy scale (AMES) is one of the established tools available to measure athletes’ perceived mental energy state. To date, there is no validated questionnaire to assess athletic mental energy for Chinese adolescents. Therefore, purpose of this study was to validate a Chinese version of AMES (C-AMES) among the Chinese adolescents in Lanzhou, Gansu Province, China. We sampled 729 adolescents aged 14 to 18 in five middle schools in Lanzhou City, Gansu Province, China to complete the revised C-AMES. Data were analyzed for factor structure validity by performing CFA. The results showed that the fit index was acceptable (RMSEA = 0.050, CFI = 0.962, TLI = 0.951), and a six-factor model containing 18 C-AMES items had good measurement properties for athletic mental energy. We suggest future study may use C-AMES to examine the relationship between athletes’ mental energy and athletic performance and sporting behavior.

Social Cluster and Heritage Memory: A Study on the Space Perception of Zhaozhou Basin Horse Caravan Vernacular Architecture

Located in Dali, Yunnan, the Zhaozhou basin is home to many precious architectural heritages, particularly the historical horse caravan architecture. These buildings face the challenge of renewal and transformation. It is of great significance to explore the local population’s awareness of the architectural heritage of the horse caravan in order to protect the architectural heritage and facilitate rural revitalization. This study reviews the related research on “space perception”, establishes a theoretical framework of space perception under the architectural dimension, and develops hypotheses. The social cluster of typical settlements in the Zhaozhou basin is selected as the research object, and empirical analyses are carried out using SPSS and AMOS software. An analytical framework model of empirical research is constructed to evaluate the space perception of the current social population. The results of the reliability and validity tests of the questionnaire show that the CR is greater than 0.7 and that the AVE is greater than 0.5. The value of the structural equation model fitting index χ2/df is 1.863, which is less than 3. The model test results show that research hypotheses H1–H5 are supported; that is, space perception has a significant positive impact on cognition and local identity, cognition has a significant positive impact on local identity and space function, and place identity has a significant positive impact on space appeal. This study demonstrates the relationship between space perception and the architectural remains of the horse caravan, and it analyzes the human psychological perception behind the material space. The findings support the need for further conservation of the horse caravan architecture. This study further deepens the theory of space perception and its application in the study of vernacular architecture, which can provide a research path for the protection and development of vernacular architectural heritage.

Construction and validation of a scale to assess knowledge, attitude, and practice regarding vascular protection anticipatory to the creation of an arteriovenous fistula.

The possibility of creating an arteriovenous fistula (AVF) depends on the existence of an arterial-venous network that is in good condition, defined by the size and elasticity of the blood vessels. The knowledge, attitudes, and practices (KAP) toward vascular protection play a crucial role in preserving the vascular network for patients with end-stage renal disease (ESRD), it is observed that there is a significant lack of tools to measure these variables. Thus, the aim of this study is to develop and validate a scale to assess KAP regarding vascular protection anticipatory to the creation of an arteriovenous fistula (the KAP-VPAC-AVF Scale). Initial item development was guided by a literature review and clinical experience, after which the items were improved and perfected through the Delphi process. The content of the scale was judged by an expert panel for content validity. In a convenience sample of 551 patients with ESRD, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine the instrument's factor structure. The KAP-VPAC-AVF Scale encompasses 11 items distributed over three factors: knowledge, attitude, and practice, demonstrated excellent internal consistency (Cronbach's alpha = 0.917) and construct validity, as confirmed by CFA with satisfactory fit indices (χ2/df = 2.394, RMSEA = 0.075, RMR = 0.049, CFI = 0.969, GFI = 0.936, AGFI = 0.892, TLI = 0.957, IFI = 0.970). The KAP-VPAC-AVF Scale is a scientific and effective assessment tool that can evaluate the KAP of ESRD patients regarding measures to preserve the vascular network.

Automatic mapping of winter wheat planting structure and phenological phases using time-series sentinel data

The precise extraction of winter wheat planting structure holds significant importance for food security risk assessment, agricultural resource management, and governmental decision-making. This study proposed a method for extracting the winter wheat planting structure by taking into account the growth phenology of winter wheat. Utilizing the fitting effect index, the optimal Savitzky–Golay (S–G) filtering parameter combination was determined automatically to achieve automated filtering and reconstruction of NDVI time series data. The phenological phases of winter wheat growth was identified automatically using a threshold method, and subsequently, a model for extracting the winter wheat planting structure was constructed based on three key phenological stages, including seeding, heading, and harvesting, with the combination of hierarchical classification principles. A priori sample library was constructed using historical data on winter wheat distribution to verify the accuracy of the extracted results. The validation of fitting effect on different surfaces demonstrated that the optimal filtering parameters for S–G filtering could be obtained automatically by using the fitting effect index. The extracted winter wheat phenological phases showed good consistency with ground-based observational results and MOD12Q2 phenological products. Validation against statistical yearbook data and the proposed priori knowledge base exhibited high statistical accuracy and spatial precision, with an extracting accuracy of 94.92%, a spatial positioning accuracy of 93.26%, and a kappa coefficient of 0.9228. The results indicated that the proposed method for winter wheat planting structure extracting can identify winter wheat areas rapidly and significantly. Furthermore, this method does not require training samples or manual experience, and exhibits strong transferability.

The Chinese version of patient experience with treatment and self-management (PETS vs. 2.0): translation and validation in patients with multimorbidity in primary care in Hong Kong

BackgroundValidated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care.MethodologyThe translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach’s alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity.ResultsThe mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ2/df = 1.741; root mean square error of approximation (RMSEA) = 0.038; standardized root mean square residual (SRMR) = 0.058; comparative fit index (CFI) = 0.911; Tucker-Lewis Index (TLI) = 0.903). All standardized factor loadings were 0.30 or above. Significant positive correlations between the latent factors were found for all factor pairs (correlation coefficient < 0.8).ConclusionsThe Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained.

Workload of home care nurses: Italian adaptation, validity, and reliability of the National Aeronautics and Space Administration Task Load Index questionnaire.

The aim of this study was to adapt the National Aeronautics and Space Administration Task Load Index (NASA-TLX) to the home care setting and translate and validate it in Italian. An online questionnaire containing the Italian version of the NASA-TLX adapted to the home care setting was administered to home care nurses to measure workload. Content Validity Index, Exploratory, and Confirmatory Factor Analyses were used to measure the psychometric characteristics of the modified NASA-TLX. The modified Italian version of NASA-TLX_HC-IT showed good psychometric characteristics in measuring the workload of home care nurses, with excellent fit indices. The reliability, calculated with Cronbach's alpha, was 0.73, indicating adequate reliability. A negative correlation between workload and job satisfaction among home care nurses, as well as a positive association between high workload and intention to leave the workplace, was verified. The modified Italian version of the NASA-TLX_HC-IT was confirmed to be a valid and reliable instrument to measure workload in home care nursing. Furthermore, the correlation between workload and the intention to leave the workplace among home care nurses was an important result that community nursing managers should consider preventing the shortage of home care nurses.

How should coronaphobia Be conceptualized? Evaluating competing models of the COVID-19 Phobia Scale using confirmatory factor analysis

Coronaphobia represents the fears and phobias attributed to the COVID-19 virus and pandemic. The COVID-19 Phobia Scale, previously validated as a four-factor structure, is a widely used multidimensional measure to assess coronaphobia. The current study scrutinized various competing factor structures of this instrument to identify the optimal psychometric representation of coronaphobia. Adults (N = 412) ranging in age from 19 to 84 years completed the COVID-19 Phobia Scale. Several theoretically plausible factor structures of coronaphobia were tested and compared using confirmatory factor analysis: four-factor structure, one-factor structure, higher-order factor structure, and five-factor bifactor structure. The one-factor structure showing an overarching factor of COVID-19 phobia revealed the poorest fit to the data. The five-factor bifactor structure that allowed every item to double-load on the COVID-19 general phobia factor alongside one of the COVID-19 specific phobia factors (psychological phobia, psycho-somatic phobia, economic phobia, or social phobia) produced the strongest fit indices and was superior to the widely accepted four-factor structure. The five-factor bifactor structure demonstrated multi-group measurement invariance across gender, race, age, and state urbanization. Furthermore, the general phobia factor and the psycho-somatic phobia factor from the five-factor bifactor structure uniquely predicted present moment state anxiety using structural equation modeling. This psychometric investigation underscores that coronaphobia is experienced as a general pandemic fear that is simultaneously experienced with specific domains of pandemic fears. Theoretical and methodological insights are offered for conceptualizing and measuring coronaphobia and understanding how pandemic phobias differ from traditional phobias.

The development of an indicator model for administrative management of faculty of physical education Thailand national sport university the road to a sport learning organization in ASEAN

This research aimed to examine the congruence of an indicator model for administrative management of Faculty of Physical Education Thailand National Sports University, the road to a sports learning organization in ASEAN with the empirical data. The research was implemented in 3 phases. The phase 1 aimed to study an administrative management indicator of Faculty of Physical Education, Thailand National Sports University, the road to a sports learning organization in ASEAN. An in-depth interview was used with 5 key informants selected by a purposive selection method. The instruments used were an in-depth interview and analytic induction. The phase 2 aimed to make indicators of administrative management of Faculty of Physical Education, Thailand National Sports University, the road to a sports learning organization in ASEAN. Key informants included 17 experts selected by a purposive selection method. The instrument used was a rating scale questionnaire to conclude the findings and determine administrative management indicators for Faculty of Physical Education, Thailand National Sports University, the road to a sports learning organization in ASEAN for the benefits of harmony and accuracy. The phase 3 aimed to examine the congruence of administrative management indicators for Faculty of Physical Education, Thailand National Sports University, the road to a sports learning organization in ASEAN. The sample comprised instructors, students of Faculty of Education and stakeholders, 490 persons in total. The instruments used in this phase were a rating scale questionnaire and confirmatory factor analysis. The research results indicated that 1) there were 5 aspects of the competency-based learning management indicator for professional education teacher students as follow: 1. Factors of administrative management mechanism, 10 indicators, 2. Factors of instructor quality, 6 indicators, 3. Factors of learning management, 17 indicators, 4. Factors of student capability enhancement, 9 indicators, 5. Factors of athlete capability enhancement to excellence, 7 indicators, 49 indicators in total. All of them were consistent, 2) the factor measurement model was consistent with the empirical data. It was found that the model was well congruent with the empirical data, considered from the relative Chi-square that was 0.487(well consistent), GFI (Goodness of Fit Index) was 0.674 (well consistent), AGFI (Adjusted Goodness of Fit Index) was 0.482 (fairly consistent), and RMSEA was 0.05 (fairly consistent). Therefore, the null hypothesis stating that the research model was congruent with the empirical data.

Development and Validation of a Malay Version Questionnaire to Evaluate Remote Health Monitoring of COVID-19 via Telehealth Applications: Navigating Telehealth Evolution.

Introduction The rapid adoption of telehealth services due to the COVID-19 pandemic has highlighted the necessity for effective tools to evaluate patient experiences. This study developed and validated the Telehealth Usability, Acceptability, and Satisfaction Questionnaire (TUASQ) for virtual COVID-19 Assessment Centres (CACs) in Malaysia, aiming to comprehensively measure usability, acceptability, and satisfaction. Methodology The TUASQ was developed in two phases. Initially, the questionnaire development phase included item generation guided by the Technology Acceptance Model (TAM) and the Health Belief Model (HBM), with feedback from a panel of six experts. Items were refined through Content Validity Index (CVI) - Item-Level Content Validity Index (I-CVI) ≥ 0.82, Scale-Level Content Validity Index (S-CVI) ≥ 0.82, and Content Validity Ratio (CVR ≥ 0.78); and Face Validity Index (FVI) by 10 respondents - Item-Level Face Validity Index (I-FVI) ≥ 0.82and Scale-Level Face Validity Index (S-FVI ≥ 0.82). The psychometric validation phase involved a cross-sectional study of 705 respondents, recruited through convenience sampling from March to July 2024, to perform Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), followed by reliability testing using Cronbach's alpha, Composite Reliability (CR), and Average Variance Extracted (AVE). Results Content validation showed that most items' I-CVI exceeded 0.82, indicating significant expert consensus on relevance and clarity. The CVR also surpassed the 0.78 threshold, affirming their essential role. Face validation indices generally exceeded 0.80, confirming the questionnaire's clarity and comprehensiveness from the users' perspective. EFA with 250 participants indicated a high Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) of 0.933 and significant Bartlett's test (χ² (136) = 3752.698, p < 0.001), supporting the factorability of the data and extracting three distinct factors. CFA with 455 participants initially showed a poor fit, prompting model adjustments that subsequently improved the fit indices (Root Mean Square Error of Approximation (RMSEA) = 0.076, Standardized Root Mean Square Residual (SRMR) = 0.045, Goodness of Fit Index (GFI) = 0.94, Tucker-Lewis Index (TLI) = 0.96, Comparative Fit Index (CFI) = 0.97). Reliability testing revealed a high internal consistency with Cronbach's alpha of 0.975. CR for each factor exceeded the 0.70 threshold, and the AVE for each factor was above 0.50, indicating good convergent validity. Conclusion The validated TUASQ is a reliable and effective instrument for assessing the experiences of Malaysian patients using virtual CAC. Demonstrating robust psychometric properties through comprehensive validation processes, the TUASQ accurately measures usability, acceptability, and satisfaction, identifying strengths and areas for improvement in telehealth services. This contributes to enhanced care quality and patient satisfaction in the evolving healthcare landscape.

Associations Among Lifetime Discrimination Typologies and Psychological Health in Black and Hispanic Women After Birth

ObjectiveTo identify lifetime discrimination typologies and examine their associations with psychological health outcomes among Black and Hispanic women after birth. DesignSecondary analysis of the Community and Child Health Network study data. ParticipantsA total of 1,350 Black and 607 Hispanic women. MethodsWe built two latent class models for Black and Hispanic women using eight indicator variables from different life domains of discrimination (childhood, family, work, police, education, housing, health care, and loans). We used bivariate and multiple regression analyses to examine the association among the identified typologies and postpartum depression and perceived stress at 6 months postpartum. ResultsWe selected the three-class model with best fit indices and interpretability: no lifetime discrimination (n = 1,029; 76.22%), high childhood–family racial discrimination (n = 224, 16.59%), and moderate lifetime discrimination (n = 97, 7.19%) among Black women and no lifetime discrimination (n = 493, 81.22%), high childhood–family racial discrimination (n = 93, 15.32%), and high education discrimination (n = 21, 3.46%) among Hispanic women. The adjusted postpartum depression and perceived stress scores were significantly greater in Typologies 2 and 3 than Typology 1 in Black women. The adjusted perceived stress scores were significantly greater in Typologies 2 and 3 than Typology 1 in Hispanic women. ConclusionLifetime discrimination experiences manifested in complex patterns. Women who experienced moderate to high discrimination across all or specific life domains had worse postpartum depression and perceived stress at 6 months after birth. It is crucial to address lifetime discrimination to improve maternal mental health.

Examining the psychometric properties of the self-efficacy in clinical teaching scale with undergraduate nursing students: A cross-sectional study

AimThis paper aimed to examine the psychometric properties of a modified version of the Self-Efficacy in Clinical Teaching Scale with a sample of undergraduate nursing students. BackgroundEnhancing nursing students’ self-efficacy in clinical teaching is important for developing their clinical teaching capabilities, which ultimately contributes to safe quality healthcare. Little is known about nursing students’ self-efficacy in clinical teaching, potentially due to a lack of validated instruments to measure their self-efficacy in clinical teaching. DesignThis study used a cross-sectional survey design. MethodsIn 2022, a convenience sample of Year 2 and Year 3 nursing students in an Australian Bachelor of Nursing Program completed the modified Self-Efficacy in Clinical Teaching Scale. The scale’s construct validity was assessed using known-group measures (year level and peer teaching experience) and confirmatory factor analysis. Concurrent validity was established through correlation with a visual analogue scale and reliability was tested with Cronbach’s alpha. ResultsThree hundred and nineteen surveys were analysed. The mean total self-efficacy in clinical teaching score for Year 2 participants was significantly lower than that of Year 3 participants (mean difference = −11.13, 95 % CI [-16.33, −5.93]). Participants with peer teaching experience had a significantly higher mean total score compared with those without peer teaching experience (mean difference = 15.32, 95 % CI [8.74, 21.91]). The scale’s relative chi-square test was acceptable (CMIN/df = 4.69); other fit indices were within or just outside acceptable parameters (RMSEA =.11; SRMR =.039; NFI =.89; RFI =.88; IFI =.91; TLI =.90; CFI =.91). There was a strong correlation between participants’ total self-efficacy in clinical teaching scores and their visual analogue scale scores (r =.83, n = 314, p <.001 [two-tailed]). Cronbach’s alpha for the total scale was .98. ConclusionsThe modified Self-Efficacy in Clinical Teaching Scale was sensitive to student year level and peer teaching experience. When subjected to confirmatory factor analysis, the scale’s model was an acceptable fit across several indices. These findings support an argument for the scale’s construct validity. Total self-efficacy scores were strongly correlated with visual analogue scales, suggesting concurrent validity. Using Cronbach’s alpha, the scale was found to be reliable, however may benefit from a reduction of item numbers. The modified Self-Efficacy in Clinical Teaching Scale may support future investigations of undergraduate nursing students’ self-efficacy in clinical teaching and contribute to an understanding of health professional students’ self-efficacy in clinical teaching across disciplines.

Development and Preliminary Validation of the Chinese Version of the Totally Implantable Venous Access Port Self-Management Behavior Scale (CPTSMBS) for Patients with Cancer.

This study aimed to develop the Chinese version of the totally implantable venous access port (TIVAP) self-management behavior scale for patients with cancer to provide a reliable tool for medical staff to judge patients with TIVAP self-management behavior. This study employed a mixed-method exploratory design. The initial scale was developed through a literature review, expert meetings, and two-round Delphi expert consultation. The reliability indicators included retest reliability and Cronbach's alpha coefficients. The validity indicators included content, construct, convergent, discriminant, and criterion validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed for the validity analysis; 22 venous therapy experts participated in the Delphi expert consultation. A total of 500 patients were recruited from two third-class A hospitals in Guangdong Province, China, between July 2020 and January 2021 to test reliability and validity. A convenience sampling method was adopted. The final scale comprised seven dimensions and 29 items. The content validity index (S-CVI) was 0.990. Cronbach's alpha coefficient and retest reliability of the scale were 0.931 and 0.900, respectively. The EFA results indicated a seven-factor structure, accounting for 65.68% of the total data variance. The results of the CFA showed that the CMIN/DF value was 2.348; the root mean square error of approximation value was 0.06; and the values of comparative fit index, incremental fit index, and Tucker-Lewis index were all >0.90. The factor loadings for all the items were >0.50, the composite reliability value was >0.70, and the average variance extracted (AVE) value was >0.50. Moreover, all absolute values of the correlation coefficients were less than the square root of the AVE for the seven dimensions. The total scores between the health promoting lifestyle profile-II revise (HPLP-IIR) and CPTSMBS were positively correlated (r = 0.465, p < 0.01). The scale demonstrated good reliability and validity and can be applied in clinical practice to evaluate self-management behavior among patients using a TIVAP.

Pain Predictors in Patients in the Postanesthesia Care Unit

To analyze the effects of pain-predicting factors on patients in the postanesthesia care unit (PACU). This is an observational and prospective study. This study was conducted at a University Hospital in the state of Minas Gerais (Brazil). To collect data on demographic, clinical, and surgical factors, a collection instrument was devised. The verbal numerical scale was employed to measure pain levels before and after surgery in the PACU. A path analysis was used to assess a predictive model. A total of 226 patients were included in this study. The incidence of pain in the PACU was 31.9%. A model with demographic, clinical, and surgical variables was tested. The final model, after including modification indices, obtained results that indicated an acceptable data fit (comparative fit index=0.996; root mean square error of approximation=0.08). Age (being young), sex (being a woman), oncological diagnosis as an indication for the surgical procedure, type of surgery (surgery of the digestive system), duration of surgery (longer surgeries), and high intraoperative doses of opioids were predictive variables for pain in the PACU. This study's findings provide support for pain management in the PACU. Furthermore, the results of this research can be used to anticipate the occurrence of acute postoperative pain and personalized perioperative analgesia needs.