Fit Indices Research Articles

Impact of electronic customer relationship management on competitive advantage: Mediating role of customer satisfaction in EgyptAir

In today’s highly competitive business environment, organizations, particularly in the airline industry, are increasingly adopting electronic customer relationship management (E-CRM) to enhance customer engagement and achieve a competitive edge. This study aims to analyze the impact of E-CRM on the competitive advantage of EgyptAir, focusing on customer satisfaction as a mediating factor. Employing a descriptive and analytical methodology, the paper surveyed 355 EgyptAir customers, utilizing a structured questionnaire to gather data on E-CRM practices, customer satisfaction, and competitive advantage. The findings reveal a significant positive correlation between E-CRM and competitive advantage, with a correlation coefficient (R) of 0.56 and a determination coefficient (R²) of 0.315, indicating that E-CRM accounts for 31.5% of the variance in competitive advantage. Furthermore, the results demonstrate that customer satisfaction significantly mediates this relationship, with E-CRM explaining 43.9% of the variance in customer satisfaction (R² = 0.439) and a direct positive impact of customer satisfaction on competitive advantage (R = 0.38, R² = 0.247). Path analysis using AMOS v.24 confirmed these findings, showing both direct and indirect effects of E-CRM on competitive advantage through customer satisfaction. The model fit indices (CFI = 0.894, RMSEA = 0.000) suggest a robust model. The study underscores the crucial role of E-CRM in fostering customer satisfaction and enhancing competitive advantage in the airline industry, providing valuable insights for airlines aiming to leverage E-CRM for sustainable success. Acknowledgments The authors are thankful to the Deanship of Graduate Studies and Scientific Research at University of Bisha for supporting this work through the Fast-Track Research Support Program.

Measuring patient-reported distress from breast magnetic resonance imaging: Development and validation of the MRI-related distress scale (MRI-DS).

Although breast magnetic resonance imaging (MRI) is a valuable screening tool, breast MRI testing burden was associated with cancer worry and quality of life. We aimed to develop and validate the MRI-related distress scale (MRI-DS) to assess comprehensive distress specifically related to breast MRI. We enrolled women aged above 18 years, diagnosed breast cancer, had MRI examination at least one time, and who could speak and read Korean in phase I and enrolled women aged above 18 years, visited outpatient clinic of breast general surgery, had undergone MRI examination at least once, and could speak and read Korean in phase II. We excluded patients who had any physical or psychiatric conditions in both phases. We recruited from a tertiary university-based hospital in South Korea between April and August 2023. All 18 items had acceptable levels of item correlation (≥0.30) in the explanatory factor analysis with a four-factor solution. The fit indices for the four-factor solution model were good. The discriminant validity of the MRI-DS had a moderate correlation with general anxiety or quality of life. In the known-group analysis, those who reported MRI as the most burden breast examination had higher total scores. The validity of the MRI-DS has been confirmed as a scale for measuring the specific distress caused by breast MRI. The MRI-DS is recommended to health professional to communicate with patients with MRI. It can be used to assess the distress associated with MRI screening in breast cancer patients. Physician could use MRI-DS to discuss the reasons for distress caused by breast MRI screening and to address specific sources of discomfort associated with it.

Cultural adaptation and psychometric evaluation of the Italian version of the Active-Empathic Listening Scale among undergraduate nursing students: a three phase validation study

AimTo translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Active Empathic Listening Scale (AELS-It) for first year students on a Bachelor degree in nursing. BackgroundActive and empathic listening is characterised by the active and emotional involvement of the listener and is particularly important for nurses to understand and address patients’ needs. When nurses demonstrate to patients that they are active and empathic listeners, it leads to deeper engagement and trust, strengthens the nurse-patient relationship and enhances the quality of care. Consequently, it is essential to incorporate active and empathic listening into nursing education, as it equips future nurses to communicate and respond to patients’ needs effectively. AELS is a tool that measures active and empathic listening styles. To the best of our knowledge, no study has validated and psychometrically tested AELS among nursing students and no studies have examined the application of the AELS scale within the Italian context. DesignA three-phase cross-sectional validation study. MethodsThe tool was first translated into Italian and adapted according to the recommendations of Beaton et al. (2000). A panel of 12 experts in nursing education evaluated the face and content validity. The psychometric properties of the Italian AELS (AELS-It) were assessed in a sample of nursing students. The dimensionality and construct validity of the tool were tested through exploratory and confirmatory factor analyses. Reliability was estimated using both traditional and composite methods. ResultsA total of 207 students were included. The overall content validity index was 0.9. The exploratory factor analysis confirmed a three factor structure. Confirmatory factor analysis showed a second-order factor structure with adequate fit indices. The reliability of the second-order factor analysis for the scale was adequate, with Cronbach’s α (0.877) and Composite-ω (0.875). ConclusionsThe Italian version of AELS-It proved to be a reliable tool to test active empathic listening in Italian nursing students and it could be a useful instrument in nursing education.

Scale to Evaluate Employee Experience: Evidence of Validity and Reliability in Regular Basic Education Teachers in the Peruvian Context.

Research on employee experience is a topic that has been growing in recent decades. This study analyzes the validity and reliability of an employee experience scale in Peruvian teachers. The study had an instrumental design. The sample was comprised of 760 Peruvian teachers between 20 and 71 years old (M = 40.91; SD = 10.05), where men (36.1%) and women (63.9%) participated, recruited through non-probabilistic sampling. A validity and reliability analysis of the employee experience scale confirmed the three original factors (sensory experience, intellectual experience, and emotional experience). The KMO test reaches a high level (0.950 > 0.70), and the Bartlett test reaches a highly significant level (Sig. = 0.000). The scale also showed good internal consistency (α = 0.948 to 0.980; CR = 0.950 to 0.981; AVE = 0.864 to 0.878). Similarly, for the confirmatory factor analysis, a measurement adjustment was performed, obtaining excellent and acceptable fit indices for Model 2 for three factors (CMIN/DF = 4.764; CFI = 0.984; SRMR = 0.024; RMSEA = 0.070). This study provides a useful tool to measure the employee experience in a friendly way, using simple language to be applied to the Peruvian context. This study is considered an important contribution to organizational behavior and human talent management in educational circles.

Psychometric properties of Self-Compassion Scale Short Form (SCS-SF) in Spanish adolescents

BackgroundSelf-compassion, individual's ability to treat oneself kindly, is important for mental well-being. The Self-Compassion Scale (SCS) is the most used instrument to measure self-compassion, but the short form does not have validity evidence in adolescents. MethodsWe examined the psychometric properties of the SCS-SF (12 items) in 955 Spanish adolescents (Mage = 13.95) using Confirmatory Factor Analysis (CFA) and reliability tests. The life satisfaction, family satisfaction, and reactive-proactive aggression were used for convergent validity. ResultsCronbach's alpha reliability value for the total scale was .723. CFA confirmed that the six-factor model showed good fit indices with three positive dimensions: self-kindness, common humanity, and mindfulness; and three negative components: self-judgment, isolation, and over-identification (χ2 = 114.730; CFI = .966; GFI = .98; RMSEA = .045). The bifactorial model also showed an adequate fit, although with weaker values than the six-factor (ꭓ2 = 247.108; CFI = .914; GFI = .95; RMSEA = .06). The unifactorial model showed an inadequate fit. Total SCS score correlated positively with family satisfaction (r = .43; p < .001) and life satisfaction (r = .48; p < .001) and negatively with reactive aggressiveness (r = −.27; p < .001) and with proactive aggressiveness (r = −.18; p < .001). Self-kindness, common humanity, and mindfulness were associated with higher family and life satisfaction (p < .001) Self-judgment, isolation, and over-identification were associated with lower family and life satisfaction (p < .001). Self-judgment and isolation positively correlated with both reactive and proactive aggression (p < .001), while mindfulness negatively correlated with both reactive and proactive aggression (p < .01). ConclusionThe SCS-SF is a valid and reliable instrument for assessing self-compassion in Spanish adolescents. Results suggest the six-factor model in its first validation in an adolescent population with convergent validity. The findings of this study corroborate the significance of self-compassion for the mental health of adolescents, particularly in relation to their family and life satisfaction.

Assessing Competencies, Needs, and Satisfaction With the Transition From Pediatric to Adult Health Care in Rheumatology: Development and Validation of the Transition-KompAZ.

The aim of this study was to develop and psychometrically validate a self-report instrument to assess (1) competencies, (2) needs, and (3) satisfaction among youth transitioning from pediatric to adult rheumatology. The Transition-KompAZ was developed in several steps with conceptual and psychometric analyses. To test its psychometric properties, the instrument was administered to adolescents and young adults (AYAs; 16-25 years) with inflammatory rheumatic diseases before (group 1) or after (group 2) transfer to adult rheumatology. A 2-factor, higher-order confirmatory factor analysis (CFA) model was applied to test the hypothesized factor structure. Internal consistency was estimated using the approach of Raykov with the factor loadings and error variances estimated in the CFA. Spearman rank correlation coefficients were used to assess construct validity. The Transition-KompAZ includes the following modules: (1) competencies in transition (knowledge, self-management), (2) needs (healthcare services, information), and (3) satisfaction (general, transitional care). A total of 173 AYAs (group 1: n = 86; group 2: n = 87) from 12 rheumatology sites completed the Transition-KompAZ. It showed good model fit (comparative fit index > 0.9; Tucker-Lewis index > 0.9; weighted root mean square residual < 0.9) with good internal consistency. The instrument demonstrated moderate-to-good construct validity and good test-retest reliability. The Transition-KompAZ appears to be a reliable tool for assessing important dimensions of transition. It may support a structured and individualized transition, as well as the evaluation of transition services. However, further studies are required to assess its predictive value in terms of transfer readiness and successful transition.

Psychometric Properties of the Chinese Version of the Gratitude at Work Scale in Employed Nurses: A Cross-Sectional Study.

The Gratitude at Work Scale, originally developed by American scholars, has been widely administered to mental health professionals and human service workers to explore gratitude in the workplace. No Chinese-language instrument is currently available for assessing workplace gratitude. The aims of this study were to (a) translate the original English version of the Gratitude at Work Scale into a traditional Chinese version (TC-GAWS), confirm its factor structure, and analyze its psychometric properties among newly employed nurses and (b) develop and evaluate the psychometric properties of the TC-GAWS short form. A psychometric study using a cross-sectional web-based design was conducted in Taiwan. Three hundred twenty-two employed nurses completed a battery of self-administered online questionnaires that included a demographic datasheet, the Gratitude Questionnaire-Six-Item Form, the Connor-Davidson Resilience Scale-10, and the Thoughts of Quitting Scale. IBM SPSS 24.0 and AMOS 28.0 were used for data analysis, and Cronbach's alpha and Pearson's correlation were used to assess reliability and concurrent validity. Exploratory factor analysis and confirmatory factor analysis (CFA) were conducted. The internal consistency and stability of the TC-GAWS total scale were .88 and .91, respectively. The exploratory factor analysis showed a satisfactory Kaiser-Meyer-Olkin value of .88 and a Bartlett's test value of 654.01 ( p < .001), suggesting that 64.55% of the total variance was explained by the two-factor TC-GAWS. After item reduction, the CFA of the six remaining items of the TC-GAWS short form revealed adequate fit statistics for a two-factor structure and a second-order factor. Strong correlations were found between the 10-item and six-item TC-GAWS ( r > .94) in the two samples, suggesting good concurrent validity. The overall scores for the 10-item and six-item TC-GAWS had similar convergent validity, with moderate-to-strong correlations for the Gratitude Questionnaire-Six-Item Form ( r = .45 and .540), Connor-Davidson Resilience Scale-10 ( r = .49 and .51), and Thoughts of Quitting Scale ( r = -.57 and -.53). The CFA yielded a two-factor, six-item model that exhibited good fit with the latent constructs of χ 2 / df = 11.06/8 = 1.38, p = .198, comparative fit index = .996, goodness-of-fit index = .979, root mean square error of approximation = .045, root mean square residual = .030, and standardized root mean squared residual = .023. Both the 10- and six-item TC-GAWS instruments demonstrated good reliability and validity in nurse participants. The TC-GAWS may be used to measure gratitude in nurses in the workplace. This instrument has the potential to facilitate a better understanding of gratitude in nurses, which may be applied to the improvement of nursing management, research, and education.

Malay Translation and Validation of the Oslo Sports Trauma Research Center Questionnaire on Health Problems.

The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H) is a proven surveillance method to register acute injury, overuse injury, or illness in athletes. However, it has not yet been translated into Malay. To translate, culturally adapt, and validate the OSTRC-H into Malay using internationally established guidelines. Cohort study (diagnosis); Level of evidence, 3. The Malay translation of the OSTRC-H (OSTRC-H.M) was distributed to 54 elite (ie, professional) and recreational athletes. Face validity, content validity, and construct validity were assessed for the validity measurement properties, while test-retest and internal consistency were used for reliability measurement properties. The content validity index was satisfactory at 0.93. The OSTRC-H.M showed good internal consistency, with a Cronbach α value of .84. Confirmatory factor analysis showed a good model for construct validity, with values of 0.99 and 0.04 for comparative fit index and root mean square error of approximation, respectively. Per-item intraclass correlation coefficients (ICCs) for test-retest reliability ranged from 0.55 to 0.80. The overall test-retest reliability of the questionnaire was good (ICC, 0.8; 95% CI, 0.63-0.88; P < .001). The OSTRC-H.M was found to be valid and reliable and therefore acceptable for application among Malay-speaking athletes.

Summary Measure of Health-Related Quality of Life and Its Related Factors Based on the Chinese Version of the Core Healthy Days Measures: Cross-Sectional Study.

The core Healthy Days measures were used to track the population-level health status in the China Chronic Disease and Risk Factor Surveillance; however, they were not easily combined to create a summary of the overall health-related quality of life (HRQOL), limiting this indicator's use. This study aims to develop a summary score based on the Chinese version of the core Healthy Days measures (HRQOL-5) and apply it to estimate HRQOL and its determinants in a Chinese population. From November 2018 to May 2019, a multistage stratified cluster survey was conducted to examine population health status and behavioral risk factors among the resident population older than 15 years in Weifang City, Shandong Province, China. Both exploratory factor analyses and confirmatory factor analyses were performed to reveal the underlying latent construct of HRQOL-5 and then to quantify the overall HRQOL by calculating its summary score. Tobit regression models were finally carried out to identify the influencing factors of the summary score. A total of 26,269 participants (male: n=13,571, 51.7%; mean age 55.9, SD 14.9 years) were included in this study. A total of 71% (n=18,663) of respondents reported that they had excellent or very good general health. One summary factor was extracted to capture overall HRQOL using exploratory factor analysis. The confirmatory factor analysis further confirmed this one-factor model (Tucker-Lewis index, comparative fit index, and goodness-of-fit index >0.90; root mean square error of approximation 0.02). Multivariate Tobit regression analysis showed that age (β=-0.06), educational attainments (primary school: β=0.72; junior middle school: β=1.46; senior middle school or more: β=2.58), average income (≥¥30,000 [US $4200]: β=0.69), physical activity (β=0.75), alcohol use (β=0.46), self-reported disease (β=-6.36), and self-reported injury (β=-5.00) were the major influencing factors on the summary score of the HRQOL-5. This study constructs a summary score from the HRQOL-5, providing a comprehensive representation of population-level HRQOL. Differences in summary scores of different subpopulations may help set priorities for health planning in China to improve population HRQOL.

Preliminary Validity and Reliability of the Persian Version of The Situational Motivation Scale for use in Academic Sport Contexts

Motivation is one of the most important psychological factors in recognising human behavior in different settings. The purpose of this study was to analyse the reliability and validity of the Persian version of the Situational Motivation Scale (P-SIMS) developed by Guay et al., (2000) in academic sport settings. A total of 231 undergraduate students, 113 males (51.6%) and 106 females (48.4%), participated in the study. The P-SIMS consists of 16 items and four subscales: intrinsic motivation, identified regulation, external regulation, and amotivation. Cronbach's alpha coefficient, interclass correlation coefficient (ICC), confirmatory and exploratory factor analysis was used to determine the internal consistency of subscales, temporal reliability, construct validity of the scale respectively. The Standardized estimate of 16 questions shows that the CFI, GFI, and NNFI indexes are above 0.90 and the RMSEA index is below 0.08, indicating the acceptability of the fit indexes. Also, the results of the calculations performed to estimate the reliability of the scale factors show that the value of the Cronbach's alpha coefficient and interclass correlation coefficient (ICC) are good enough and considering that the internal consistency coefficients and temporal reliability of the components of the list are reasonable and appropriate, the reliability of the scale is confirmed. The results showed that P-SIMS has relatively acceptable construct validity and acceptable internal consistency and test-retest reliability. The results of this study support the preliminary validity and reliability of the P-SIMS for use in academic sport contexts.

Measuring the quality of self-care of elderly patients with dementia in a developing country.

In developing countries like Uganda, people with dementia are cared for by non-medically trained family members with minimal support from the formal healthcare system. The quality of care in this setting is largely unknown but significantly affects the well-being of those with dementia. A tool designed to measure the quality of informal care for old frail adults with or without dementia was translated into Luganda. A committee of experts reviewed and finalized the translation, which was pilot-tested and then used to measure the quality of dementia self-care. We consecutively enrolled 105 caregivers of elderly people with dementia; the median age was 35 years (Interquartile Range 26-47 years), and 67% were females, taking care of a grandparent (44%) or a parent (34%). We used confirmatory factor analysis to assess for structural validity and computed correlation coefficients and Cronbach's alpha to assess for discriminant validity and internal reliability, respectively. The three-factor model applied to the 20 items, adequately fit the data (Comparative Fit Index = 0.88, Tucker-Lewis Index = 0.87, Root Mean Square Error of Approximation = 0.08; 90% Confidence Interval (0.06-0.09), Standardized Root Mean Square Residual = 0.089). There was good discriminant validity, and correlation coefficients between dimensions/scales and the Dementia Knowledge Assessment Scale scores were low. There was good internal reliability with all items Cronbach's alpha ranging from 0.69 to 0.89. Our findings demonstrated that this culturally adapted, shorter measurement tool is valid and reliable. The tool can be used by researchers, health workers, and agencies to assess the quality of self-care for elderly people with dementia in Uganda.

Cardiorespiratory fitness and body mass index on metabolic syndrome in middle-aged Japanese adults under national health guidance: a cross-sectional study

ObjectivesPoor cardiorespiratory fitness (CRF) and high body mass index (BMI) increased the risk of developing metabolic Syndrome (MetS) mostly in Caucasians. However, the sex-specific combined association of CRF and BMI on MetS considering health-related behaviors has yet to be thoroughly examined in Japanese. This study aims to investigate the sex-specific independent and combined associations of CRF and BMI with MetS in middle-aged Japanese adults.Methods421 participants were included in this cross-sectional study. CRF was estimated using a submaximal cycle ergometer. CRF and BMI were respectively divided into three categories according to tertile distribution. MetS was diagnosed based on five risk factors: waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose. Multivariable logistic regression models were used to estimate independent and combined association of CRF and BMI with MetS.ResultsResults showed that 154 (57.5%) and 70 (45.8%) of men and women had MetS, respectively. Compared to men with lower CRF or higher BMI, men with middle and higher CRF or middle and lower BMI were less likely to have MetS. Compared with ‘unfit and higher BMI’ group, ‘unfit and lower BMI’, ‘fit and higher BMI’, and ‘fit and lower BMI’ groups in men showed statistically significant decreased prevalences of MetS. However, no significant associations were found in women.ConclusionsThis study found significant independent and combined associations of CRF and BMI with MetS only in men, but not in women. However, prospective studies are warranted to confirm sex-specific associations of CRF and BMI with MetS.

Energy consumption prediction and energy-saving suggestions of public buildings based on machine learning

Energy consumption prediction can help the government to formulate building energy consumption quotas and buildings energy consumption correlation analysis can provide a clear direction for buildings energy conservation and renovation. In the study, the energy consumption data of four types of public buildings in Guangxi in the four quarters of 2021 based on five machine learning models was trained and predicted. The energy consumption data was analyzed for correlation based on two methods of influencing factor correlation analysis. Finally, based on the prediction model and correlation analysis results, suggestions for energy conservation and renovation were given to eight buildings. The results showed that compared to other models, CNN had higher prediction accuracy, and the fitting regression index was generally above 0.95. The season had little impact on the characteristics correlation, but the building type had a significant impact. The electricity consumption had a high correlation with the energy consumption of all types of buildings. Through case analysis, it was concluded that some buildings did not need energy-saving renovation for the time being, while others require multiple phases of energy reduction over several quarters to meet the requirements.

Synergizing teacher collaboration to foster active learning strategies, student engagement and achievement in physics: a unified analysis across nine countries

This investigation explores the nexus between professional teacher collaboration, active learning methodologies, teaching promoting student engagement in physics classes and physics achievement. Leveraging Trends in International Mathematics and Science Study Advanced 2015 data from 1729 physics instructors across nine countries, it probes the extent to which collaborative practices among teachers influence their teaching to enhance active learning and engagement. Analytical techniques include Spearman correlations, confirmatory factor analysis, and structural equation modeling. Results reveal a robust model, confirmed by a Comparative Fit Index of 0.989 and Tucker–Lewis Index of 0.988, suggesting a good fit with the empirical data, alongside a Root Mean Square Error of Approximation of 0.053. The analysis demonstrates that teacher collaboration (‘Collab’) significantly predicts active learning (‘Active’) with a notable effect (β = 0.344, p < 0.001), which in turn significantly enhances student engagement (‘Engage’) (β = 0.438, p < 0.001). Additionally, ‘Engage’ is also directly influenced by ‘Collab’ (β = 0.174, p < 0.001). Although the relationship between ‘Collab’ and physics achievement (‘Physics’) is weaker, it remains significant (β = 0.063, p = 0.019). These findings support the enhancement of teacher collaboration as a catalyst for active learning and student engagement, which could indirectly foster improvements in physics achievement globally.

Effects of coaches' autonomy support on athletes' aggressive behavior and athlete burnout: verification of the mediating effects of coach-athlete relationship and team efficacy.

This study investigated the relationships between perceived autonomy support, coach-athlete relationship, team efficacy, aggressive behavior, and athlete burnout among team sports athletes. It verified the mediating effects of the coach-athlete relationship and team efficacy on the relationship between autonomy support and athlete burnout. A questionnaire survey on autonomy support, coach-athlete relationships, aggressive behavior, and athlete burnout was administered to 336 team sports athletes (292 male athletes and 44 female athletes). A cross-sectional research design was used to collect the data. To analyze the collected data, frequency, reliability, descriptive statistical, and correlation analyses were performed using SPSS version 26.0. In addition, confirmatory factor analysis, convergent validity tests, and structural model analysis were conducted using AMOS version 24.0. Bootstrapping was used to examine the mediating effects. The fit of the measurement model was assessed by calculating the fit indices as follows: x 2 = 329.689, df = 124, p < 0.001, TLI = 0.945, CFI = 0.956, RMSEA = 0.070 (90% CI = 0.061-0.080), and SRMR = 0.060. Autonomy support positively affected the coach-athlete relationship (β = 0.841) and team efficacy (β = 0.338). The coach-athlete relationship positively affected team efficacy (β = 0.479). Furthermore, autonomy support did not significantly influence aggressive behavior (β = -0.053), and negatively affected athlete burnout (β = -0.305). The coach-athlete relationship also did not significantly affect aggressive behavior (β = 0.054), and negatively affected athlete burnout (β = -0.303). Team efficacy negatively affected aggressive behavior (β = -0.516) and athlete burnout (β = -0.201). Finally, autonomy support was found to affect athlete burnout through the coach-athlete relationship and team efficacy. Considering that autonomy support affects athlete burnout through coach-athlete relationship and team efficacy, coaches need to enhance the quality of the coach-athlete relationship and improve team efficacy to reduce athlete burnout. Above all, the study findings suggest that coaches need to provide autonomy-supportive behaviors.

Equivalence Testing Based Fit Index: Standardized Root Mean Squared Residual

A popular measure of model fit in structural equation modeling (SEM) is the standardized root mean squared residual (SRMR) fit index. Equivalence testing has been used to evaluate model fit in structural equation modeling (SEM) but has yet to be applied to SRMR. Accordingly, the present study proposed equivalence-testing based fit tests for the SRMR (ESRMR). Several variations of ESRMR were introduced, incorporating different equivalence bounds and methods of computing confidence intervals. A Monte Carlo simulation study compared these novel tests with traditional methods for evaluating model fit. The results demonstrated that certain ESRMR tests based on an analytic computation of the confidence interval correctly reject poor-fitting models and are well-powered for detecting good-fitting models. We also present an illustrative example with real data to demonstrate how ESRMR may be incorporated into model fit evaluation and reporting. Our recommendation is that ESRMR tests be presented in addition to descriptive fit indices for model fit reporting in SEM.

Validation of the Learner Engagement Instrument for Continuing Professional Development.

Learner engagement is the energy learners exert to remain focused and motivated to learn. The Learner Engagement Instrument (LEI) was developed to measure learner engagement in a short continuing professional development (CPD) activity. The authors validated LEI scores using validity evidence of internal structure and relationships with other variables. Participants attended 1 of 4 CPD courses (1 in-person, 2 online livestreamed, and 1 either in-person or livestreamed) in 2018, 2020, 2021, and 2022. Confirmatory factor analysis was used to examine model fit for several alternative structural models, separately for each course. The authors also conducted a generalizability study to estimate score reliability. Associations were evaluated between LEI scores and Continuing Medical Education Teaching Effectiveness (CMETE) scores and participant demographics. Statistical methods accounted for repeated measures by participants. Four hundred fifteen unique participants attended 203 different CPD presentations and completed the LEI 11,567 times. The originally hypothesized 4-domain model of learner engagement (domains: emotional, behavioral, cognitive in-class, cognitive out-of-class) demonstrated best model fit in all 4 courses, with comparative fit index ≥ 0.99, standardized root mean square residual ≤ 0.031, and root mean square error of approximation ≤ 0.047. The reliability for overall scores and domain scores were all acceptable (50-rater G-coefficient ≥ 0.74) except for the cognitive in-class domain (50-rater G-coefficient of 0.55 to 0.66). Findings were similar for both in-person and online delivery modalities. Correlation of LEI scores with teaching effectiveness was confirmed (rho=0.58), and a small correlation was found with participant age (rho=0.19); other associations were small and not statistically significant. Using these findings, we generated a shortened 4-item instrument, the LEI Short Form. This study confirms a 4-domain model of learner engagement and provides validity evidence that supports using LEI scores to measure learner engagement in both in-person and livestreamed CPD activities.

Childhood maltreatment and vulnerability to substance use disorders: The mediating role of psychological security.

Understanding the factors associated with the propensity for drug dependence might be helpful in providing the best strategies for substance use prevention among youth. The present study was conducted to examine the association between childhood maltreatment (CM) and susceptibility to substance use disorders (SUDs), taking into account the mediating role of psychological safety. In this cross-sectional study, multistage cluster sampling was employed to recruit 400 male students from the three universities of Tabriz in 2019. Research instruments included the valid and reliable scales of substance abuse, childhood trauma, and mental safety. Data were analyzed using Pearson correlation, and structural equation modeling. The results showed positive significant relationships between vulnerability to SUDs, CM, and low levels of psychological safety. The evaluation of our hypothetical research model using fit indices showed that the model fits well the measurement model (CFI=0.97, GFI=0.95, RMSEA=0.058). Our proposed theoretical model suggested psychological security as a mediator between CM and SUDs. CM explained addiction in college students through reducing psychological security. Investigating these interactive processes seems to be detrimental, considering that they may enhance our understanding of the ways to reduce the risk.

Linking patient safety, caring behaviours and professional self-efficacy with missed nursing care among Filipino emergency room nurses: A structural equation model study.

To investigate the interrelationships of patient safety, caring behaviours, professional self-efficacy and missed nursing care among emergency room nurses. Cross-sectional, correlational study. Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self-report scales were used to collect data and were analysed using Spearman rho, covariance-based structural equation modelling, mediation and path analyses. The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self-efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self-efficacy and missed nursing care, respectively. Professional self-efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self-efficacy were significant mediators between the association of patient safety and missed nursing care. Caring behaviours and professional self-efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care. Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self-efficacy to minimize avoidable injuries and omitting nursing care tasks. STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). No Patient or Public Contribution.

Development, reliability, and validity of the telerehabilitation satisfaction questionnaire in neurological diseases

BackgroundMeasuring satisfaction with telerehabilitation provides a way to evaluate and improve the effectiveness of both the technology used and the rehabilitation provided. On the other hand, valid and reliable tools are needed to evaluate satisfaction of patients receiving physiotherapy via telerehabilitation. AimsThe purpose of the current study was to develop Telerehabilitation Satisfaction Questionnaire (TrSQ) and evaluate its validity and reliability. MethodsSixty-three patients with stroke, Multiple Sclerosis, or Parkinson’s disease participated in this study. Content validity was reviewed by a panel experienced in telerehabilitation. Construct validity of the model was investigated using and Confirmatory Factor Analysis (CFA) and Explanatory Factor Analysis (EFA). Test-retest reliability and Internal consistency were used to evaluate the reliability of the TrSQ. ResultsA one-factor structure was determined based on EFA. The structure fitted well in terms of the fit indices according to the confirmatory factor analysis results (x2/df = 1.016, p = 0.442, IFI=0.997, CFI=0.997, and RMSEA=0.016). The questionnaire was proven to have an acceptable reliability level (Cronbach’s alpha = 0.858) and it was found that all items were necessary. Finally, an 11-item version was obtained and tested twice on 30 patients. The questionnaire was shown to have acceptable test–retest reliability (ICC=0.753). ConclusionsTrSQ can be used as a valid and reliable questionnaire in evaluating patient satisfaction with telerehabilitation in neurological diseases. However, in order for it to be widely applicable, adaptation to different languages is needed.